| NPI | 1922148550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN C. DAGLEY President 972-291-9165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2017-12-04 |