| NPI | 1639121718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA MOORE Practice Manager 770-619-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 029664) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-08-24 |