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General NPI Number Information
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NPI Number | 1558506030
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Entity Type | Organization
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Legal Business Name | THE PAIN TREATMENT AND WELLNESS CENTER
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 245 HUMPHREY RD STE 2
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City | GREENSBURG
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State | PA
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Zip | 15601-4580
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Country | US
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Telephone | 724-853-2353
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Fax | 724-853-2354
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Provider Business Mailing Address
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Address Line | 245 HUMPHREY RD SUITE 2
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City | GREENSBURG
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State | PA
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Zip | 15601-4580
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Country | US
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Telephone | 724-853-2353
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Fax | 724-853-2354
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. JEFFREY ALAN LUTZ
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Credential | CMTPT
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Telephone | 724-853-2353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC002346L
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License Number State | PA
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