| NPI | 1255803318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GROYSMAN Sole Member 469-600-6241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 208VP0000X Pain Medicine Pain Medicine | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2022-01-07 |