Healthcare Provider Details

I. General information

NPI: 1568534402
Provider Name (Legal Business Name): PAIN ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 COMMONS BLVD SUITE 240
BEAVERCREEK OH
45431-3820
US

IV. Provider business mailing address

2510 COMMONS BLVD SUITE 240
BEAVERCREEK OH
45431-3820
US

V. Phone/Fax

Practice location:
  • Phone: 937-429-8620
  • Fax: 937-429-8629
Mailing address:
  • Phone: 937-429-8620
  • Fax: 937-429-8629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH ANN O'CONNELL
Title or Position: OWNER
Credential: D.O.
Phone: 937-429-8620