NPI | 1124787940 |
---|---|
Entity Type | Organization |
Authorized Contact | CRAIG W CARMICHAEL President 309-824-8670 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Enumeration Date | 2021-12-09 |
Last Update Date | 2022-01-12 |