| NPI | 1639992894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA MICHELLE PATINO Chief Operating Officer 833-626-8724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2024-11-06 |