| NPI | 1104889534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT O GRADY Vice President 239-432-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2014-08-05 |