| NPI | 1538925581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS R LIDDELL Owner, Medical Doctor 605-595-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |