| NPI | 1720646250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MARIE HENRY CEO 833-834-7246 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |