| NPI | 1255520037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNA BEDELL Accounts Manager 435-755-0964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: UT 329116-1204) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: UT 329116-1204) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2013-07-18 |