| NPI | 1083130520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN PIERRE GIBERT Owner 843-801-4005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2022-07-21 |