| NPI | 1588646244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLA TURBERVILLE Credentialing Manager 850-474-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2010-01-21 |