| NPI | 1669021663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RA'KERRY RAHMAN Owner 346-291-5357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |