NPI | 1104590512 |
---|---|
Entity Type | Organization |
Authorized Contact | KIRK GEORGE BOWDEN Owner 480-889-0255 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 207L00000X Anesthesiology |
207LP2900X Anesthesiology, Pain Medicine | |
208VP0000X Pain Medicine, Pain Medicine | |
Enumeration Date | 2021-08-09 |
Last Update Date | 2021-08-09 |