Segments- Reconciles Segments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Adjusted EBITDA	$ 19,258	$ 13,409	$ 50,960	$ 35,059
Depreciation	(2,404)	(1,786)	(5,587)	(4,816)
Amortization	(1,807)	(1,294)	(4,364)	(3,691)
Interest	(5,742)	(2,159)	(9,921)	(6,140)
Acquisition costs	(1,960)	(113)	(5,425)	(3,479)
Stock based compensation expense	(1,601)	(1,224)	(4,747)	(2,678)
Purchase accounting adjustment to inventory	(2,403)		(2,403)	(1,502)
Non same-store revenue	2,583	1,472	6,254	2,775
Non same-store costs	(5,394)	(3,845)	(12,690)	(6,667)
Fair value adjustment of contingent note	(2,310)	350	(3,090)	(250)
Integration costs and costs of discontinued clinics	(1,166)	(57)	(2,308)	(813)
Clinic launch expenses	(672)	(50)	(672)	(1,261)
Non-recurring royalty settlement				(440)
SKU Rationalization	(6,482)		(6,482)
Pretax net (loss) income	(10,100)	4,703	(475)	6,097
Income tax benefit (expense)	1,304	(801)	(77)	(754)
Net (loss) income	(8,796)	3,902	(552)	5,343
Products | Operating Segments
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Adjusted EBITDA	20,506	14,642	56,030	41,337
Services | Operating Segments
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Adjusted EBITDA	7,048	5,217	18,147	13,049
Unallocated Corporate | Corporate, Non-Segment
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Adjusted EBITDA	$ (8,296)	$ (6,450)	$ (23,217)	$ (19,327)