Healthcare Provider Details

I. General information

NPI: 1154480168
Provider Name (Legal Business Name): COMPLETE PAIN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 N HOLLAND SYLVANIA RD SUITE 100
TOLEDO OH
43615-1006
US

IV. Provider business mailing address

3700 N HOLLAND SYLVANIA RD SUITE 100
TOLEDO OH
43615-1006
US

V. Phone/Fax

Practice location:
  • Phone: 419-534-9823
  • Fax: 419-534-9837
Mailing address:
  • Phone: 419-534-9823
  • Fax: 419-534-9837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: JAMES S BASSETT JR.
Title or Position: OWNER
Credential: M.D.
Phone: 419-534-9823