NPI | 1952003618 |
---|---|
Entity Type | Organization |
Authorized Contact | TAHA SIDERS Chief Operating Officer 262-577-0250 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2023-03-20 |
Last Update Date | 2023-03-20 |