Healthcare Provider Details

I. General information

NPI: 1336642313
Provider Name (Legal Business Name): MEDICAL ANALGESIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 13TH AVE N
CLINTON IA
52732-5067
US

IV. Provider business mailing address

PO BOX 689
LAKE FOREST IL
60045-0689
US

V. Phone/Fax

Practice location:
  • Phone: 563-243-2511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PRESCHER
Title or Position: OWNER
Credential: MD
Phone: 800-444-6110