| NPI | 1588117063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET KELLER VP Operations 460-563-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 35497) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |