| NPI | 1275350910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY THADDEUS CLAVO Medical Director 404-354-0153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy |
| 164X00000X Licensed Vocational Nurse | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |