| NPI | 1689316309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP L. BEAULIEU Owner/Director/Md 615-815-1560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |