NPI | 1730696956 |
---|---|
Entity Type | Organization |
Authorized Contact | KENDALL EDWARD CARLL Owner/Manager 469-693-0165 |
Organization Subpart ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX M8573) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN6843) |
Enumeration Date | 2018-01-09 |
Last Update Date | 2019-06-11 |