| 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 Chiropractor, Rehabilitation | 
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-10-01 | 
| Last Update Date | 2014-10-01 |