Healthcare Provider Details

I. General information

NPI: 1013346428
Provider Name (Legal Business Name): COMPREHENSIVE PAIN SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 BRENT LN
PENSACOLA FL
32503-2104
US

IV. Provider business mailing address

PO BOX 11637
PENSACOLA FL
32524-1637
US

V. Phone/Fax

Practice location:
  • Phone: 850-484-4080
  • Fax: 850-484-8801
Mailing address:
  • Phone: 850-476-7072
  • Fax: 850-484-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFF BUCHALTER
Title or Position: OWNER
Credential: MD
Phone: 850-476-7072