| NPI | 1528350048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LUTZ Office Manager 651-313-8254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 30820) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2017-03-23 |