| NPI | 1194281758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY P LOCKETT Medical Director 727-443-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |