| NPI | 1306304050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA SAYLES Credentialing Auditor 864-642-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2024-01-17 |