| NPI | 1548923246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUY RUTLEDGE FOGEL Provider 210-057-5470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-19 |