| NPI | 1568899581 |
|---|---|
| Doing Business As | PROVIDENCE SURGICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | KELLY MOWRER Credentialing Specialist 216-472-2741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-07 |