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 | 207QS0010X Family Medicine, Sports Medicine |
207X00000X Orthopaedic Surgery | |
Enumeration Date | 2021-12-16 |
Last Update Date | 2024-12-12 |