Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1730409400 |
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| LBN Legal business name | EYE BONE, LLC | ||||||||
| Authorized official | AUGUSTINE KELLIS - (PRESIDENT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 06/04/2010 | ||||||||
| Last updated | 04/25/2023 - About 3 years ago | ||||||||
| Identifiers |
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