| NPI | 1174902605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY P PANOZZO Owner 309-721-3288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 34922) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2016-11-18 |