| NPI | 1770257180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK GEORGE BOWDEN Owner 480-889-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology Pain Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2023-07-10 |