| NPI | 1225522063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYNNDEL BUENGER Medical Director 618-465-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2020-01-21 |