| NPI | 1245204494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY J BROUSSARD President 910-484-2171 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-08-06 |