| NPI | 1285873240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SCOTT BALTER President 308-236-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2010-11-24 |