Organization
MOSS CREEK SPORT & SPINE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT GAVIN JR. M.D. (CEO)
(843) 681-5077
Entity
Organization
Contact information
Practice address
15 MOSS CREEK VILLAGE, HILTON HEAD, SC 29926
(732) 804-2812
Mailing address
13 FOX DEN CT, HILTON HEAD, SC 29926-2561
(732) 804-2812
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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