| NPI | 1669789889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S. MASIMORE Authorized Official 317-346-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2019-02-27 |