| NPI | 1619524097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEA JEANINE WALTON Rcs Manager 704-316-6081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-06-24 |