| NPI | 1831698703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL E CARLL Owner 469-693-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |