| NPI | 1114608411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALAN MOORE Co Owner 346-646-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 207Q00000X Family Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-07-28 |