| NPI | 1124578703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANESH MAZLOOMDOOST President 859-275-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: KY TC537) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |