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 |