NPI | 1619794328 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY THADDEUS CLAVO Medical Director 404-354-0153 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
261QP3300X Clinic/Center, Pain | |
Enumeration Date | 2024-09-24 |
Last Update Date | 2024-09-24 |