Provider First Line Business Practice Location Address: 
400 RAY C HUNT DR
    Provider Second Line Business Practice Location Address: 
UNIVERSITY OF VIRGINIA DEPARTMENT OF ORTHOPAEDIC SURG
    Provider Business Practice Location Address City Name: 
CHARLOTTESVILLE
    Provider Business Practice Location Address State Name: 
VA
    Provider Business Practice Location Address Postal Code: 
22903-2980
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
434-243-0265
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
09/23/2009