| NPI | 1952592719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN ADAMS VP Of Finance And CFO 217-466-4246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 2084P2900X Psychiatry & Neurology Pain Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2024-09-30 |