| NPI | 1679664882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MELISSA GREENLEY Billing Administrator 302-832-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-07-06 |