| NPI | 1578176087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BUCKNER Sole Owner 480-930-4018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-11-05 |