| NPI | 1205698396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SACKDINANH NOK KEOMAHATHAI Owner 470-274-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-06-03 |