| NPI | 1922367895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY C. KOCH Owner 724-934-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA DC004706L) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA DC004706L) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA DC004706L) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |