| NPI | 1538682216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE VIRDIS GRAY Physician Owner 704-896-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2023-11-14 |