| NPI | 1790045409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN PHILLIPS Office Manager 910-805-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 20698) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NC 20698) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2013-01-16 |