| NPI | 1063895753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES COKER Administrator 904-374-6498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: FL 261QP3300X) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |