| NPI | 1811507924 |
|---|---|
| Other Name | CENTURA MEDICAL GROUP PAIN SPECIALISTS PORTER |
| Other Name | DIMENSIONS PAIN MANAGEMENT AT PAH |
| Doing Business As | PSPA PAIN SPEC PAH |
| Entity Type | Organization |
| Authorized Contact | JASON TACHA COO 303-304-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2024-05-14 |