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General NPI Number Information
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NPI Number | 1376851691
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN THERAPY PA
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 601 E 14TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5972
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Country | US
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Telephone | 660-826-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 7180 W 107TH ST STE 16
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2523
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Country | US
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Telephone | 913-642-5330
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Fax | 913-642-3172
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. PERIAPATNA S ANANTH
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Credential | MD
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Telephone | 913-530-2259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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