| NPI | 1932848678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS PETERSON Authorized Official 509-947-7944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-10-05 |