Healthcare Provider Details
I. General information
NPI: 1407938822
Provider Name (Legal Business Name): COMPREHENSIVE HEADACHE AND PAIN SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10945 REED HARTMAN HIGHWAY SUITE # 219 217
CINCINNATI OH
45242
US
IV. Provider business mailing address
4211 LIGHTHOUSE LANE
WEST CHESTER OH
45069
US
V. Phone/Fax
- Phone: 513-891-3600
- Fax: 513-891-3601
- Phone: 917-282-3668
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | 87875 |
| License Number State | OH |
VIII. Authorized Official
Name:
JAVARIA
AHSAN
USMANI
Title or Position: OFFICE MANAGER
Credential:
Phone: 718-619-7461