NPI | 1275363210 |
---|---|
Entity Type | Organization |
Authorized Contact | KELSEY ROPER Office Administrator 844-365-7246 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
208VP0000X Pain Medicine Pain Medicine | |
Enumeration Date | 2024-08-05 |
Last Update Date | 2024-08-05 |