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General NPI Number Information
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NPI Number | 1609984608
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT CENTERS PC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5625 WATER TOWER PL SUITE 220
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City | CLARKSTON
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State | MI
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Zip | 48346-2671
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Country | US
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Telephone | 248-620-4265
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Fax | 248-620-4262
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Provider Business Mailing Address
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Address Line | 1701 LAKE LANSING RD SUITE 100
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City | LANSING
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State | MI
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Zip | 48912-3798
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Country | US
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Telephone | 517-485-0001
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Fax | 517-485-1138
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Authorized Official
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Title or Position | OWNER
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Name | ASHRAF I KHAN
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Credential | DO
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Telephone | 248-620-4265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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