| NPI | 1508601691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEAN WILLIAM FREAS CEO 410-571-2946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 225100000X Physical Therapist | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |