NPI | 1619702792 |
---|---|
Entity Type | Organization |
Authorized Contact | VADIM PETROV-KONDRATOV Owner 912-910-3777 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
Enumeration Date | 2024-09-06 |
Last Update Date | 2024-09-06 |