Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1417333295 |
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| LBN Legal business name | IDOX3 LLC | ||||||||
| Authorized official | JENNIFER STROHMEYER - (SUPERVISOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 08/04/2015 | ||||||||
| Last updated | 07/23/2020 - About 6 years ago | ||||||||
| Identifiers |
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