| NPI | 1275631459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY M CLASSEN Medical Director 817-332-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-01-09 |