| NPI | 1831359215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID O LANE Administrator 203-755-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207X00000X Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2013-02-27 |