| NPI | 1023815099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD MAUTNER Owner 813-928-8037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2025-02-28 |