| NPI | 1184813669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE KROEKER Office Manager 805-434-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A76013) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2010-10-22 |