| NPI | 1164652970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W DAVIS Sole Manager 410-335-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2013-11-04 |