Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1508643610 |
| LBN Legal business name | 787 ORTHO ASC LLC |
| Authorized official | SARAH SANFORD - (MEMBER MANAGER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/12/2023 |
| Last updated | 02/04/2025 - More than a year ago |
| Identifiers | n/a |
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