| NPI | 1528270782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY D VILIMS Owner 866-356-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: WY 7671A) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: WY 7671A) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-10-03 |