| NPI | 1205569373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CALES Owner 502-492-7455 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |