| NPI | 1598424699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M GRIMES Sole Member 904-814-8365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2024-04-01 |