| NPI | 1851857312 |
|---|---|
| Former Legal Business Name | SUBODH K AGRAWAL |
| Entity Type | Organization |
| Authorized Contact | CHRISTAL DAWN DOBBS Administrator 706-296-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2020-04-24 |