| NPI | 1952114126 |
|---|---|
| Other Name | TIDALHEALTH PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | WILLIAM PELOT Chief Administrative Officer 410-543-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-07-22 |