NPI | 1902109549 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL RHEAD COTTAM Owner/Provider 855-655-7389 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: UT 6655906-1205) |
Enumeration Date | 2010-12-20 |
Last Update Date | 2022-01-10 |