| NPI | 1447768197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY RICHARDSON Owner/Md 909-709-5646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2023-06-14 |