Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0101266649 | VA |
NPI | 1013329390 |
---|---|
Provider Name | Christopher Betzle |
First Address | Roanoke, VA 24014-1111 |
Second Address | Kalamazoo, MI 49007-5354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 06/08/2020 |