| NPI | 1700198884 |
|---|---|
| Doing Business As | SPORTS MEDICINE AND ORTHOPAEDIC CENTER OF LAKE CUMBERLAND |
| Entity Type | Organization |
| Authorized Contact | SARA MILLER Director 615-920-7514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363A00000X Physician Assistant | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2017-09-27 |