NPI | 1306823596 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J GAVIN Network Administrator 318-212-4232 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
Enumeration Date | 2005-12-28 |
Last Update Date | 2012-06-08 |