| NPI | 1720372311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANGELA RUSSO-STRINGER Owner 225-243-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: LA MD.201475) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |