| NPI | 1700351400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XAVIER ORLANDO BRENT Practice Manager 678-782-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2019-03-26 |