| NPI | 1962186437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MICHAEL MANN Medical Director 800-698-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-09-19 |