NPI | 1306429287 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE PROFFITT Credentialing & Enrollment 804-533-2357 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 207X00000X Orthopaedic Surgery |
Enumeration Date | 2021-04-29 |
Last Update Date | 2022-06-03 |