| NPI | 1932549540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN DIAZ Owner/Director 678-232-0109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2019-09-24 |