NPI | 1245767672 |
---|---|
Entity Type | Organization |
Authorized Contact | MISTY HOOKS Billing/Credentialing Supervisor 229-238-0265 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Enumeration Date | 2017-05-16 |
Last Update Date | 2021-04-14 |