| NPI | 1720322811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYON SCOTT RAYNES President 850-469-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME69848) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-08-08 |