| NPI | 1518708635 |
|---|---|
| Doing Business As | NERVE RENEWAL STILLWATER |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY C BALES Owner/CEO 405-724-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |