| NPI | 1922615830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT CHRISTOPHER PUCKETT President 904-634-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2022-12-12 |