| NPI | 1376210807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY BANKS Owner 313-510-8861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |