| NPI | 1801315635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE FULLAWAY Owner 609-505-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 171100000X Acupuncturist | |
| 207X00000X Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2024-05-09 |