| NPI | 1730372350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JOHN KEOGH Owner 251-633-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AL MD24656) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2019-10-09 |