| NPI | 1730666553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN STEPHENS Provider 703-209-0735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101054622) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |