| NPI | 1164164455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL COCHRAN Practice Manager 844-777-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |