| NPI | 1902256233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY LEE WHITE President 877-750-1027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX G1581) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |