| NPI | 1871104836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIR M ELGHOR Owner 320-230-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2023-07-12 |