| NPI | 1801938642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA VELTEN Billing Clerk 812-207-2092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: KY 22779) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 22779) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2011-11-02 |