| NPI | 1588296503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BUCKNER Sole Memeber 480-930-4018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-21 |