Healthcare Provider Details

I. General information

NPI: 1518252691
Provider Name (Legal Business Name): COMPREHENSIVE PAIN SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

IV. Provider business mailing address

3328 WESTBOURNE DR
CINCINNATI OH
45248-5133
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-2204
  • Fax: 513-922-2009
Mailing address:
  • Phone: 513-922-2204
  • Fax: 513-922-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35084075
License Number StateOH

VIII. Authorized Official

Name: MICHAEL J. BERTRAM
Title or Position: OWNER
Credential: MD
Phone: 513-922-2204