| NPI | 1144735267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN COIT KRUG Director 904-591-4150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2018-01-10 |