| NPI | 1215003082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R HERON President 920-498-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2014-12-18 |