| NPI | 1992003339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J EDMISTON Owner 704-360-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 200000410) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2023-03-07 |