| NPI | 1609586858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA M GROTH Credentialing 904-223-3321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2022-11-29 |