| NPI | 1942603212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RIEMANN Clinic Director 251-445-3340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 111NR0400X |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |