| NPI | 1992049118 |
|---|---|
| Doing Business As | BLUE MOUNTAIN SURGERY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D. SHAFMAN President 401-456-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2019-07-19 |