NPI | 1871050781 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY SCOTT MASIMORE Authorized Official 317-346-7246 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Enumeration Date | 2019-02-27 |
Last Update Date | 2019-02-27 |