| NPI | 1093188096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK L. KINARD Owner 662-638-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2024-07-01 |