| NPI | 1245630557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUIE MCCONNELL Billing 725-710-9237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2024-05-21 |