| NPI | 1285908970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2022-04-13 |