| NPI | 1083631410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED K KHALOUF President 814-941-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA os004841l) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-08-22 |