| NPI | 1174324594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE HURD Owner 772-403-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-03-28 |