| NPI | 1558664920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRON MOOREHEAD Managing Member 770-218-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 064985) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 064985) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 064985) | |
| 208VP0000X (Licence: GA 064985) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 064985) | |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |