| NPI | 1255695490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RALEY Owner 703-522-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101243103) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-08-29 |