| NPI | 1316952054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY BACK Practice Manager 229-439-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2019-05-01 |