| NPI | 1336438803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD DONALD SIMMONS Owner 716-882-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 177174) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 007834) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 007619) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2012-03-22 |