| NPI | 1730765124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEANA PEREA Billing Manager 480-737-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |