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General NPI Number Information
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NPI Number | 1053596205
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL SPINE AND PAIN REHABILITATION CENTER, LTD.
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1221 S TRIMBLE RD STE B1
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City | MANSFIELD
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State | OH
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Zip | 44907-2212
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Country | US
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Telephone | 419-522-1100
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Fax | 419-522-4118
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Provider Business Mailing Address
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Address Line | 1221 S TRIMBLE RD STE B1
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City | MANSFIELD
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State | OH
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Zip | 44907-2212
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Country | US
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Telephone | 419-522-1100
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Fax | 419-522-4118
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Authorized Official
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Title or Position | MEDICAL DIRECTROR / OWNER
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Name | DR. MICHAEL FRANCIS STRETANSKI
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Credential | DO
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Telephone | 419-522-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 34.007293
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License Number State | OH
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