Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1033650817 |
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| LBN Legal business name | DICKSON ORTHOPEDICS, PA | ||||
| Authorized official | BETTY RODGERS - (OFFICE MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/14/2017 | ||||
| Last updated | 03/14/2017 - About 9 years ago | ||||
| Identifiers |
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