| NPI | 1225270689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIA PENNINGTON Executive Director 469-326-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2010-05-10 |