| NPI | 1235774019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON VIGNEAU Sole Member 623-688-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-02-07 |