| NPI | 1093091902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN EARL CUMBIE COO / CFO 478-330-5742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 9999999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 9999999) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 9999999) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 9999999) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 070274) | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2014-08-01 |