| NPI | 1457815474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E KENT Physician Owner 386-507-5269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-03-25 |