| NPI | 1104231349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BRUGGEMAN Owner 210-802-4662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-04-28 |