| NPI | 1174188965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA L BROWN Owner 727-440-5410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2020-08-10 |