| NPI | 1659836591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN M KEAN Authorized Official 252-321-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-07-31 |