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General NPI Number Information
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NPI Number | 1366627507
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Entity Type | Organization
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Legal Business Name | ACADEMY OF PAIN MANAGEMENT
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 1501 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-3021
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Country | US
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Telephone | 940-387-0019
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Fax | 940-387-0010
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Provider Business Mailing Address
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Address Line | 1501 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-3021
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Country | US
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Telephone | 940-387-0019
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Fax | 940-387-0010
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Authorized Official
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Title or Position | MANAGER
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Name | TROY M HURST
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Credential | DC
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Telephone | 940-387-0019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 7946
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License Number State | TX
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