| NPI | 1811432321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | V.K. PUPPALA Owner/Md 770-627-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 71014) |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2018-03-17 |