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General NPI Number Information
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NPI Number | 1235750431
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Entity Type | Organization
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Legal Business Name | PRECISION SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 22701 HALL ROAD
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City | MACOMB
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State | MI
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Zip | 48042
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Country | US
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Telephone | 916-698-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 22701 HALL RD
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City | MACOMB
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State | MI
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Zip | 48348-2269
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TODD BORST
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Credential |
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Telephone | 916-698-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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