| NPI | 1255603403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG STEVEN COHEN Owner 843-652-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 30634) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: SC 30634) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2013-09-23 |