| NPI | 1295032407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LODDIE CONWAY Receptionist 479-595-8192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-02-24 |