| NPI | 1205985967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER WAGNER Executive Director 440-816-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-02-28 |