| NPI | 1265614309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS DALE RICHARDSON President 870-424-4507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AR E4201) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |