| NPI | 1568809598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTAN JULIAN SHOCKLEY Medical Director 240-786-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2022-01-24 |