| NPI | 1679526669 |
|---|---|
| Doing Business As | SOUTHERN TIER SURGICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN DAHN TVETENSTRAND President 607-763-8205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 178438) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011154) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-11-19 |