| NPI | 1609844000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MATHIAS ENDRES Authorized Representative 715-552-5346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2018-11-21 |