NPI | 1679164255 |
---|---|
Doing Business As | OHMG-PAIN MANAGEMENT AND LIFESTYLE MEDICINE |
Entity Type | Organization |
Authorized Contact | RUSSELL S RANALLO Secretary 270-417-4813 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
Enumeration Date | 2021-01-27 |
Last Update Date | 2024-08-19 |