| NPI | 1033496070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY MORELAND Manager 404-543-6949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |