| NPI | 1104472414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE D. MAHANEY Owner/Authorized Official 313-593-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2020-05-19 |