| NPI | 1598133654 |
|---|---|
| Doing Business As | PSAL |
| Entity Type | Organization |
| Authorized Contact | MARICOLE TAYLOR COO 816-916-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2015-09-07 |
| Last Update Date | 2020-08-22 |