| NPI | 1124218037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK P WETHERINGTON Administrator 954-540-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL OS0004707) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL 601878) |
| 207Q00000X Family Medicine (Licence: FL 601878) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL 601878) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2024-09-19 |