| NPI | 1164661054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL NOLAN Member/Owner 260-579-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2014-09-16 |