| NPI | 1750409017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIA PENNINGTON Executive Director 469-326-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2010-11-30 |