| NPI | 1679591515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BOYER Coder 386-274-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1207) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |