| NPI | 1629229869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI PALUSO Administrator 208-748-4315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |