| NPI | 1134725757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY BEARD ADAMS Authorized Official 321-206-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |