| NPI | 1083931547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R KRUEGER Owner 270-737-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2012-08-27 |