| NPI | 1215715396 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | GLENDA B MITCHELL Doctor/ CEO 757-949-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |