NPI | 1942680194 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIE MICHAEL FUSSELL Owner And President 304-241-5160 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WV 2511) |
Enumeration Date | 2015-06-03 |
Last Update Date | 2015-06-03 |