| NPI | 1205597788 |
|---|---|
| Former Legal Business Name | KETAMINE INFUSION CENTERS |
| Entity Type | Organization |
| Authorized Contact | ANITA JERGER Executive Assistant 480-993-2227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-10 |