| NPI | 1578938395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON SAKIKO HANOWELL Owner 770-787-3550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2016-08-15 |