| NPI | 1013487362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY R FOLTZ Owner 904-449-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2021-08-20 |