| NPI | 1659323624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY RAWSON KEREKES Owner/President 302-388-0861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-02-04 |