| NPI | 1861008831 |
|---|---|
| Doing Business As | KETAMINE WELLNESS CENTERS |
| Entity Type | Organization |
| Authorized Contact | ANITA JERGER Executive Assistant 855-538-9355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 208VP0000X | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2022-08-17 |