| NPI | 1780719419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL G WADE President 520-906-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-07-03 |