| NPI | 1790854206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE MICHAEL FUSSELL Owner 724-228-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-07-21 |