| NPI | 1033522420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN B COOPER Administrator 877-298-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: GA 56072) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |