| NPI | 1245612035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIN WILLARD Managing Member 304-553-3457 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-08-10 |