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General NPI Number Information
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NPI Number | 1528063120
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Entity Type | Organization
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Legal Business Name | BREVARD ORTHOPAEDICS, PA
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 316 CHESTNUT ST STE. 2
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City | BREVARD
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State | NC
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Zip | 28712-3010
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Country | US
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Telephone | 828-884-2055
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Fax | 828-884-2834
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Provider Business Mailing Address
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Address Line | 316 CHESTNUT ST STE. 2
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City | BREVARD
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State | NC
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Zip | 28712-3010
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Country | US
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Telephone | 828-884-2055
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Fax | 828-884-2834
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. AMY J GOOD
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Credential |
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Telephone | 828-884-2055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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