| NPI | 1104559210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSY ELLEDGE Revenue Director 423-476-5774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |