| NPI | 1972774602 |
|---|---|
| Doing Business As | PAIN MANAGEMENT PSYCHOLOGY |
| Entity Type | Organization |
| Authorized Contact | LAVERL H. WILHELM Psychologist 208-676-0926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID 202060) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-06-10 |