| NPI | 1457836678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MATTHEW PETTEGREW Surgeon/Partner 209-572-3224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2018-10-03 |