| NPI | 1427571355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PABLO ZEBALLOS Owner 219-218-2484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2018-12-07 |