| NPI | 1609574177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA L ROTH VP Of Clinical Operations 084-761-5837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |