Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pain |
261QP3300X | |||
Vascular & Interventional Radiology |
2085R0204X | 94 | Physician/Interventional Radiology |
| NPI # | 1093188096 |
| LBN Legal business name | WILLOW PAIN AND WELLNESS, LLC |
| Authorized official | KIRK KINARD - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/12/2015 |
| Last updated | 07/01/2024 - More than a year ago |
| Identifiers | n/a |
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