Interventional Pain & Physical Medicine Clinic

NPI 1184978280 - Clinic/Center - 261QA1903X

NPI Details
NPI 1184978280
Enumeration Date 10/29/2012
Last Updated 10/29/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name STACY STACY
Position ADMINISTRATOR
Phone (320) 229-1500
Fax (320) 229-1505
Practice Location
2301 CONNECTICUT AVE S
SARTELL MN, 56377-2474, US
Phone (320) 229-1500
Fax (320) 229-1505
Business Location
2301 CONNECTICUT AVE S
SARTELL MN, 56377-2474, US
Phone (320) 229-1500
Fax (320) 229-1505
Toxanomy
Taxonomy Code 261QA1903X
License State
License Number
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According to our database, Interventional Pain & Physical Medicine Clinic NPI is 1184978280, taxonomy code is 261QA1903X Interventional Pain & Physical Medicine Clinic physically located at 2301 Connecticut Ave S, Sartell MN, 56377-2474. NPI Number 1033115704 has the healthcare provider type.

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1184978280 NPI number is provided on an as is basis without warranty of any kind. 1184978280 is maintained by the National Plan & Provider Enumeration System. The contents of Interventional Pain & Physical Medicine Clinic are for informational purposes only.