| NPI | 1326049370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER R FRYE Administrator 409-938-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-09-11 |