| NPI | 1215242755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN R. CARWELL President 757-481-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101025726) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: VA 0101025726) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2016-08-31 |