| NPI | 1891113155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WALTER KAYOTA Sole Owner/Authorize Official 757-496-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101053621) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101053621) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2015-04-25 |