| NPI | 1407741069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN FERRELL Executive Director 757-297-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 208600000X Surgery | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-08-28 |