| NPI | 1780661967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E JONES Medical Director 712-239-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IA NOT APPLICABLE) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-03-14 |