| NPI | 1346341476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN HASELTINE C.E.O. 904-823-3764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL OS7217) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME93573) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-01-05 |