| NPI | 1467158709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MCDONALD Managing Member 928-308-5109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-07 |