| NPI | 1063717080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY R BAILEY Administrator 606-438-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2011-01-22 |
| Last Update Date | 2011-01-22 |