NPI | 1588446439 |
---|---|
Entity Type | Organization |
Authorized Contact | JARRETT MICHAEL LEATHEM Owner 860-670-2412 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
208VP0000X Pain Medicine, Pain Medicine | |
Enumeration Date | 2023-10-16 |
Last Update Date | 2023-10-16 |