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General NPI Number Information
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NPI Number | 1023349180
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Entity Type | Organization
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Legal Business Name | PAIN REHABILITATION LLC
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 3162 N NATIONAL RD
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City | COLUMBUS
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State | IN
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Zip | 47201-3170
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Country | US
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Telephone | 812-342-4003
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Fax | 812-342-4003
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Provider Business Mailing Address
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Address Line | 3162 N NATIONAL RD
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City | COLUMBUS
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State | IN
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Zip | 47201-3170
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Country | US
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Telephone | 812-342-4003
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Fax | 812-342-4003
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY J. STRAUSBURG
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Credential | MD
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Telephone | 812-342-4003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State | IN
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