USA Board Certified Physician or a healthcare provider medical clearance/referral for a treatment 

Providers, click here to access referral form.

Please Note:Do not mail the form. We are in the process of moving our practice. Call us for instructions on how to send it to us.  - No fax service!

NPI # 1043617392

Please Note: We do NOT bill health insurance

Call us for inquiries or questions at 919.228.9559