| NPI | 1134361736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIN SMITH Owner 678-701-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 048097) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 37577) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |