| NPI | 1609944545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEV PERRIE Manager 757-253-0603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |