| NPI | 1710551585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN LEEK Sole Member 817-526-4604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |