| NPI | 1609350669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR CELIS Owner 617-372-3673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2018-09-17 |