NPI | 1487788824 |
---|---|
Entity Type | Organization |
Authorized Contact | SHIRLEY K MUCK Practice Manager 386-760-0915 |
Organization Subpart ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0027133) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME0044566) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2010-08-06 |