| NPI | 1851715833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SHEDDEN Owner 334-702-9445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine | |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2014-02-18 |