Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1245620871 |
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| LBN Legal business name | ADVANTIA SURGICAL LLC | ||||||||
| Authorized official | PETER GLASS - (CHIEF MEDICAL OFFICER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | Yes | ||||||||
| Enumeration date | 02/03/2015 | ||||||||
| Last updated | 06/28/2017 - About 9 years ago | ||||||||
| Identifiers |
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