| NPI | 1124416417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI DELBRIDGE Administrator 757-502-8570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |