| NPI | 1922576818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CORALUZZI Chief Administrative Officer 833-271-4254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |