| NPI | 1528547056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON MUIA WADE President 772-631-1741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME106167) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2020-08-03 |