| NPI | 1821843384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DANIEL PARKS Owner 334-224-0892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2024-04-18 |