| NPI | 1447791074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIGO DURALDE Owner 404-351-7654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA In process) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2020-06-11 |