| NPI | 1245764554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN TIMMONS Owner 850-462-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME42993) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2022-07-21 |