| NPI | 1609176783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS GRISSOM President 907-373-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2010-10-23 |
| Last Update Date | 2011-03-01 |