| NPI | 1760611925 |
|---|---|
| Doing Business As | RIVERLAKES PAIN AND WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFREY THOMAS FOLLANSBEE Owner/Physician 262-200-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2009-07-09 |