| NPI | 1073404877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LARSON VP Of Operations 586-260-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2026-06-12 |