| NPI | 1871979641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLU JABATI Md/Medical Director 678-559-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 058527) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 058527) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |