| NPI | 1811015399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL ROSS FOX Owner & Surgeon 253-472-9850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA MD0002094) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: WA MD00005293) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-07-21 |