| NPI | 1952678815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS S WON Owner 972-255-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2018-01-24 |