| NPI | 1033967955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB HORN Admin 341-217-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207R00000X Internal Medicine | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |