| NPI | 1598015133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIWAKAR NAGULA Owner 912-673-7074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2012-10-30 |