| NPI | 1043670532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAI MCGREEVY Owner/President 904-230-3006 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME109028) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME109028) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-03-08 |