| NPI | 1659615540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY D HOOKS Billing/Credentialing Supervisor 229-238-0265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 59158) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2021-04-07 |