| NPI | 1861689093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEHALKUMAR PARESH MODH President 636-933-7673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2019-10-17 |