| NPI | 1760693659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WILLIAM WILLOX President 518-458-2488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 231845) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 185491) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |