| NPI | 1225489511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY R BUCKNER Member/Manager 602-421-2730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-07-12 |