NPI | 1861593436 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY L RADA Billing Supervisor 318-443-9191 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
Enumeration Date | 2006-09-26 |
Last Update Date | 2020-08-22 |