| NPI | 1770740482 |
|---|---|
| Doing Business As | FAGAN SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M FAGAN Doctor/Owner 205-879-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 14105) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: AL 14105) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 14105) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2011-01-06 |