| NPI | 1497267173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSY ELLEDGE Revenue Director 423-476-5774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2022-07-06 |