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General NPI Number Information
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NPI Number | 1578800561
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Entity Type | Organization
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Legal Business Name | COMPLETE PAIN CARE LLC
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 10744 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-7982
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Country | US
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Telephone | 317-209-9811
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Fax | 317-209-9812
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Provider Business Mailing Address
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Address Line | 10744 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-7982
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Country | US
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Telephone | 317-209-9811
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Fax | 317-209-9812
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SALLY TINCHER
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Credential |
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Telephone | 765-557-8541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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