| NPI | 1043389836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYNARD BUSZEK Owner CEO 866-708-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301044005) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |