| NPI | 1053915959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WHEALTON Owner 606-280-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2024-08-30 |