| NPI | 1295330561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVEK PATEL Owner 678-505-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2020-12-03 |