| NPI | 1760464036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTIE R STAUSS Physician Services Manager 629-255-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: TN 0000000006) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2025-11-19 |