| NPI | 1144452582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOSEPH OTTAVIANI Clinic Director 386-366-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME0067232) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2009-08-19 |