| NPI | 1003523721 |
|---|---|
| Doing Business As | LIFE BALANCE PAIN CARE |
| Entity Type | Organization |
| Authorized Contact | BRAD SCOTT BOOTSTAYLOR Employee 404-275-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |