| NPI | 1497077812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL WALTERS Owner 515-659-0967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 116662) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-04-06 |