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General NPI Number Information
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NPI Number | 1144211384
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Entity Type | Organization
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Legal Business Name | KC PAIN CENTERS, LLC
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 200 NE MISSOURI RD SUITE 103
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City | LEES SUMMIT
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State | MO
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Zip | 64086-4722
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Country | US
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Telephone | 816-763-1559
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Fax | 816-965-8404
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Provider Business Mailing Address
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Address Line | 8717 W 110TH ST SUITE 600
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2144
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Country | US
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Telephone | 913-428-2900
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Fax | 913-428-2951
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Authorized Official
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Title or Position | PRESIDENT
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Name | RYAN J. GRINDSTAFF
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Credential | MD, PHD
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Telephone | 913-428-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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