| NPI | 1760242440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B DE MIRANDA Physician/CEO 479-434-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |