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General NPI Number Information
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NPI Number | 1053722397
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PAIN CARE, LLC
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 1 MARKET ST SUITE 1C
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City | CAMDEN
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State | NJ
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Zip | 08102-2308
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Country | US
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Telephone | 856-963-5314
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Fax |
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Provider Business Mailing Address
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Address Line | 41 S ROUTE 73 SUITE 200
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City | HAMMONTON
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State | NJ
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Zip | 08037-9448
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Country | US
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Telephone | 856-963-5314
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHEH LU
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Credential | DO
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Telephone | 856-963-5314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 25MB04184600
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License Number State | NJ
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