| NPI | 1912576323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE M WEBB CEO 833-378-2583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 103T00000X Psychologist |
| 207X00000X Orthopaedic Surgery | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |