| NPI | 1801910732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BENNETT JOHNSON Secretary 319-541-4219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A93613) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2020-08-22 |