| NPI | 1740798784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA M GRAVES Administrator 302-540-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |