NPI | 1710095690 |
---|---|
Entity Type | Organization |
Authorized Contact | WAYNE SMITH Administrator 318-425-8701 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 09700) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2020-08-22 |