| NPI | 1629422738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | USMAN FAYYAZ AHMAD Sole Member 704-542-3988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 2015-01401) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2018-04-12 |