| NPI | 1841226552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W SNEAD Member 239-598-2712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1205) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2013-10-14 |