| NPI | 1639710882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENDT P PETERSEN Physician 251-607-6117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2022-08-04 |