| NPI | 1356848014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA GREEN Revenue Manager 855-343-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-02-01 |