| NPI | 1639041627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DAMON GANTSOUDES Chief Medical Director 571-306-1525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine |
| 261QR0200X Clinic/Center, Radiology | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-09-22 |