| NPI | 1962180844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK GEORGE BOWDEN Owner 480-889-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |