| NPI | 1699950766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-5382 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2022-04-20 |