| NPI | 1588941629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN M WATTENMAKER Doctor 703-777-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |