| NPI | 1578981718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER NELSON Sole Member/Manager 502-423-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 37667) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |