| NPI | 1922861004 |
|---|---|
| Doing Business As | NERVE RENEWAL SHAWNEE |
| Entity Type | Organization |
| Authorized Contact | TIM COIT BALES CEO 405-501-6261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |