NPI | 1982462008 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM BRADLEY Owner 208-208-1234 |
Organization Subpart ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
Additional Taxonomies | 207X00000X Orthopaedic Surgery |
261Q00000X Clinic/Center | |
Enumeration Date | 2024-03-12 |
Last Update Date | 2024-07-08 |