| NPI | 1417342452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E STURDAVANT Owner 228-594-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MS 16798) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2015-04-06 |