| NPI | 1770082356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY JOB Owner 941-375-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-03-17 |