| NPI | 1982129136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN KENNETH BROCKMAN Physican/Owner 704-481-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 33212) |
| Additional Taxonomies | 208VP0000X (Licence: NC 33212) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2019-04-23 |