| NPI | 1285943746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP Q JOHNSON Owner 701-478-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2011-07-12 |