| NPI | 1003855420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDE COKE Office Manager 901-850-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TN 1717) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2017-11-01 |