| NPI | 1790036580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HARBERT Owner 1605-229-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma | |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |