| NPI | 1407962137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN R FASSY Owner 941-926-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME64532) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-03-27 |