| NPI | 1962045096 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JOHN RYAN EDWARDS Neurosurgeon 385-345-3560 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery | 
| Enumeration Date | 2019-10-22 | 
| Last Update Date | 2024-12-11 |