| NPI | 1962401745 |
|---|---|
| Doing Business As | MIDWEST INTERVENTIONAL SPINE SPECIALISTS,LLC |
| Entity Type | Organization |
| Authorized Contact | SHANU KONDAMURI Medical Director 219-836-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2011-03-24 |