NPI | 1609389881 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLY AMBER HOWINGTON Credentialing Specialist 580-775-5857 |
Organization Subpart ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
Additional Taxonomies | 207Q00000X Family Medicine |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
Enumeration Date | 2017-11-10 |
Last Update Date | 2018-03-28 |