| NPI | 1144856691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JULIE SHARP Owner/Manager 817-901-1686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |