| NPI | 1992382089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE CHRISTINE FISCUS Authorized Official 984-215-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2023-11-02 |