| NPI | 1568431013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE E ALT President 660-665-0817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MO-R9G62) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MO MO-R9G62) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2008-02-12 |