| NPI | 1457350951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner Family | |
| 363A00000X Physician Assistant | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 207RN0300X Internal Medicine Nephrology | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-07-21 |