| NPI | 1467006197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA BERRY Insurance Supervisor 910-287-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |