| NPI | 1922592641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA MINICOZZI Practice Manager 770-391-3979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2018-06-16 |