| NPI | 1972223394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HAMMER Administrator 269-352-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-12-19 |