NPI | 1821417692 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-8004 |
Organization Subpart ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 29836) |
Enumeration Date | 2014-04-09 |
Last Update Date | 2022-04-20 |