| NPI | 1275607129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BAYSORE Practice Administrator 423-648-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2024-10-30 |