| NPI | 1073979621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FORD Practice Administrator 678-369-6934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2019-08-13 |