| NPI | 1639483100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HANOWELL Owner 770-385-4426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 061846) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 061846) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2012-02-08 |