| NPI | 1225395718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J MOODY Administrator 912-265-5994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |