| NPI | 1982782934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE E WILSON Chief Executive Officer 765-423-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-11-27 |