| NPI | 1265311955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |