| NPI | 1750685491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 208000000X Pediatrics |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2021-10-21 |