This 3-day lab-based course is designed for IDN clinicians that want to take the next step in understanding and applying dry needling for neuromusculoskeletal pain and dysfunction. The clinician is provided a deeper research-based understanding of the physiologic and therapeutic effects of peri-neural dry needling. The negative effects of neurogenic inflammation and reduced microcirculation will be explained in relation to central and peripheral nervous system mechanisms. Advanced peri-neural, muscular and tendon needling techniques are practiced to achieve maximal clinical efficacy. Electrical nerve stimulation (ENS) will be emphasized as an important adjunct to dry needling treatment. Focus is on assuring the safe and effective clinical application of dry needling using sound clinical decision-making. Successful completion of this course results in earning the credential Certified in Integrative Dry Needling (CIDN). [Prerequisite-Foundation Course]