| NPI | 1174960926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL E MATTHEWS Sole Member 251-491-2676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL 21607) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2018-07-10 |