| NPI | 1639570328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SUTHERLAND Provider Enrollment 229-891-9131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-07-28 |