| NPI | 1730611526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J BORMAN Owner/CEO 847-894-1127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: FL ME124453) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |