| NPI | 1720195449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY DOMAYER CFO 386-231-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2021-03-03 |