| NPI | 1679880686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BRIAN JUERGENS Physician 618-993-5859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2011-03-09 |