NPI | 1881489680 |
---|---|
Entity Type | Organization |
Authorized Contact | JESNA SUSAN MATHEW SUBLETT Owner 386-222-2792 |
Organization Subpart ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery |
Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
Enumeration Date | 2025-04-11 |
Last Update Date | 2025-05-18 |