| NPI | 1619285087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTANAM SRINIVASAN Clinical Director 765-891-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2010-09-20 |