| NPI | 1093387748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TREY CRITTENDEN Owner 256-302-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2022-07-07 |