| NPI | 1548339310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ALFRED NESTEBY Owner 806-792-6193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 222Z00000X ORTHO 377) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2008-08-28 |