| NPI | 1982393179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN KELBY HUTCHESON Owner 888-699-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |