| NPI | 1154577641 | 
|---|---|
| Doing Business As | PAIN RECOVERY CENTER OF TYLER | 
| Entity Type | Organization | 
| Authorized Contact | KENNETH FULTS President 903-526-5000 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | 
| Additional Taxonomies | 111N00000X Chiropractor | 
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2008-08-15 | 
| Last Update Date | 2013-01-07 |