| NPI | 1710402029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRIAN DOOLEY Owner 563-344-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA 25065) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2019-01-22 |