| NPI | 1740528637 |
|---|---|
| Former Legal Business Name | INTERVENTIONAL PAIN MANAGEMENT SPECIALIST |
| Entity Type | Organization |
| Authorized Contact | DANIEL R KLOSTER Authorized Member 913-302-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2023-03-08 |