| NPI | 1932167863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE SUMMERLIN Administrator 757-461-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 204D00000X Neuromusculoskeletal Medicine & OMM | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2007-08-27 |