| NPI | 1003522798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK STIBBENS Chief Medical Officer 719-321-4637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-05-01 |