| NPI | 1477789964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIG J LETONOFF Owner 228-896-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS 18468) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-09-14 |