| NPI | 1770715013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMSON KANLA ORUSA President. 931-906-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TN 28275) |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain (Licence: TN 28275) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |