| NPI | 1871632604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK M CHIASSON President 520-219-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 31226) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 29820) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 2649) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-02-24 |