| NPI | 1740528637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTAY ROSS Office Manager 913-242-7570 |
| 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 | 2025-08-21 |