Healthcare Provider Details

I. General information

NPI: 1063842243
Provider Name (Legal Business Name): PAIN & INJURY CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NICOLLET MALL SUITE #1453
MINNEAPOLIS MN
55402-2606
US

IV. Provider business mailing address

825 NICOLLET MALL SUITE #1453
MINNEAPOLIS MN
55402-2606
US

V. Phone/Fax

Practice location:
  • Phone: 612-886-1562
  • Fax: 612-234-4471
Mailing address:
  • Phone: 612-886-1562
  • Fax: 612-234-4471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateMN

VIII. Authorized Official

Name: DR. KEVIN SCHNEIDER
Title or Position: PARTNER
Credential: D.C.
Phone: 612-886-1562