| NPI | 1881395689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIA LINDISAS Owner 224-999-7484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-17 |