| NPI | 1275804940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE S BUNTIN CEO 888-796-6331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A76678) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: CA A76678) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-03-21 |