| NPI | 1396709127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY ANN DEHARDT Billing Administrator 913-754-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2011-08-17 |