| NPI | 1619649258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH JACKNOWITZ Cro 469-459-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-10-18 |