| NPI | 1619426335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD DOMANGUE Owner/Partner 985-892-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |