| NPI | 1003470501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA PEINE Administrator 479-431-6990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 208VP0000X Pain Medicine Pain Medicine | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2023-05-16 |