| NPI | 1912195330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED GROESBECK Vice President 469-682-6742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2008-08-05 |