| NPI | 1881574861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MINCKLER Sole Member 520-800-6330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2025-09-02 |
| Last Update Date | 2025-09-02 |