| NPI | 1720444334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACYE ENIS Billing Manager 501-771-4693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |