| NPI | 1184193161 |
|---|---|
| Other Name | LASER SPINE BREVARD |
| Entity Type | Organization |
| Authorized Contact | MONICA JOHNSON Account Manager 425-941-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2020-08-04 |