| NPI | 1811464118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN VENGER Owner/Member Manager 928-788-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 207T00000X Neurological Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2022-07-19 |