| NPI | 1659526689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A. PAYNE Certified Billing & Coding Speciali 573-632-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2012-02-09 |