| NPI | 1144998113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA HARBISON Practice Administrator 912-428-5621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |