| NPI | 1912177478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T SELLNER CFO 623-876-6616 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |