| NPI | 1811401516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA GUICE Account Manager 331-305-2813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2017-11-17 |