| NPI | 1497230189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COSGROVE Principal 256-677-9809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |