| NPI | 1346963667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA J'NENE TRASHON REESE Owner 616-634-5365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-10-13 |