Organization
RIVERVIEW SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE DAVID BOLES MD (MD)
(812) 644-2500
Entity
Organization
Contact information
Practice address
1276 N PLAZA DR, ROCKPORT, IN 47635
(812) 649-2500
(812) 649-9427
Mailing address
1276 N PLAZA DRIVE, ROCKPORT, IN 47635
(812) 649-2500
(812) 649-9427
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2012
Last updated
02/05/2014
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