| NPI | 1508741257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLA STEPHENSON Administrator/D On 470-217-8445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |