| NPI | 1821545633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D. BEASLEY Senior Vice President 843-777-7010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2022-06-10 |