Healthcare Provider Details

I. General information

NPI: 1316441017
Provider Name (Legal Business Name): JB PAIN FREE MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 E MARKET ST STE 20
YORK PA
17402-5123
US

IV. Provider business mailing address

4075 E MARKET ST STE 20
YORK PA
17402-5123
US

V. Phone/Fax

Practice location:
  • Phone: 717-244-8504
  • Fax:
Mailing address:
  • Phone: 717-891-2405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA ARLENE WYNEGAR
Title or Position: VP OF OPERATIONS
Credential:
Phone: 717-891-2405