| NPI | 1881553642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHANATRY Manager 904-449-7643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2026-01-19 |
| Last Update Date | 2026-01-19 |