| NPI | 1518539659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL JOHNSON Manager 601-540-5450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2022-08-23 |