| NPI | 1649488057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILLILAM GILLILAND President 360-260-0235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD00042973) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |