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Organization

PREMIER SURGICAL ASSISTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WALLACE L VINSON (CERTIFIED SURGICAL ASSISTANTS)
(630) 780-8642
Entity
Organization

Contact information

Practice address
568 S WASHINGTON ST, NAPERVILLE, IL 60540-6843
(630) 369-6200
(630) 369-7200
Mailing address
568 S WASHINGTON ST, NAPERVILLE, IL 60540-6843
(630) 369-6200
(630) 369-7200

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3408
IL

Other

Enumeration date
07/13/2009
Last updated
07/13/2009
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