| NPI | 1700062486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALLEN PRATER Certified Surgical Technition 219-742-8718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2008-01-13 |
| Last Update Date | 2008-02-11 |