| NPI | 1770858391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA LESHAWN NELSON-WINTERS Owner 877-572-0954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MD R143211) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |