| NPI | 1972312809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHDEV KUPPUSAMY Owner 480-550-9393 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |