| NPI | 1124271861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HANEY Business Manager 520-421-0986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: AZ 2951) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-01-17 |