| NPI | 1639142706 |
|---|---|
| Doing Business As | AMBULATORY SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | LAXMAIAH MANCHIKANTI Medical Director 270-554-8373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 3600098) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2011-10-05 |