| NPI | 1346514833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLYE KEITZ Back Office Manager 903-465-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2021-08-02 |