| NPI | 1588936702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM RYALS Front Office Manager 985-205-3456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: LA 020305) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2015-10-12 |