| NPI | 1003195983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER N NELSON Owner 502-423-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-10-05 |