| NPI | 1437288263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY GRECO Sr. Enrollment Manager 223-341-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-11-21 |