| NPI | 1194410142 |
|---|---|
| Doing Business As | FORWARD KETAMINE |
| Entity Type | Organization |
| Authorized Contact | MATTHEW VASEY President 608-898-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-04-06 |