NPI | 1467808519 |
---|---|
Entity Type | Organization |
Authorized Contact | CHAD DOMANGUE Mbr 985-892-8934 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
Enumeration Date | 2016-05-09 |
Last Update Date | 2016-05-09 |