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General NPI Number Information
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NPI Number | 1588536197
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Entity Type | Organization
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Legal Business Name | SAGE SPINE PAIN AND NERVE CENTER
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 38500 TANGER DR STE 110
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City | NORTH BRANCH
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State | MN
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Zip | 55056-5402
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Country | US
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Telephone | 440-821-7326
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Fax |
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Provider Business Mailing Address
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Address Line | 38500 TANGER DR STE 110
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City | NORTH BRANCH
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State | MN
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Zip | 55056-5402
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Country | US
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Telephone | 651-337-8201
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Fax | 651-337-8211
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW CLARY
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Credential | DO
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Telephone | 440-821-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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