| NPI | 1740996586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEAN WILLIAM FREAS CEO 888-985-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-02-06 |