| NPI | 1396037255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MASIMORE Authorized Official 317-346-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2017-12-13 |