MEDICARE: ADVANCED PAIN RELIEF AND WELLNESS CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1083	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	372668468009	OTHER	OH	MEDICAL MUTUAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023065786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PAIN RELIEF AND WELLNESS CENTER INC

Provider Business Mailing Address
First Line	:	2828 S ARLINGTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-4726
Country	:	US
Telephone Number	:	330-896-8500
Fax Number	:	330-896-8383

Provider Business Practice Location Address
First Line	:	2828 S ARLINGTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-4726
Country	:	US
Telephone Number	:	330-896-8500
Fax Number	:	330-896-8383

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEITH S UNGAR
Credential	:
Telephone Number	:	330-896-8500

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	04/20/2008

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