| NPI | 1013489350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVER PENNY Managing Member 623-628-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2018-12-27 |