| NPI | 1992443766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORY LANCE MCJUNKIN Medical Director 480-757-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-06-27 |