NPI | 1710160601 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK CULLEN Propietor 770-814-2223 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 043191) |
Enumeration Date | 2007-12-13 |
Last Update Date | 2011-10-07 |