| NPI | 1851486328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PERKINS Administrator 276-322-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VA OH692) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |