| NPI | 1225496102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE RUDDER Medical Director 844-300-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: TX J4489) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |