| NPI | 1669845327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN P DIRKS CEO 855-255-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care |
| 207X00000X Orthopaedic Surgery | |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2024-09-27 |