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General NPI Number Information
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NPI Number | 1184254252
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF MEDICAL PLLC
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 1209 E 8TH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2938
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Country | US
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Telephone | 231-421-1025
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Fax | 231-642-9101
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Provider Business Mailing Address
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Address Line | 1209 E 8TH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2938
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Country | US
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Telephone | 231-421-1025
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Fax | 231-642-9101
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. TODD HALL
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Credential |
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Telephone | 231-421-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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