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General NPI Number Information
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NPI Number | 1639981087
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Entity Type | Organization
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Legal Business Name | SUPERIOR PAIN MANAGEMENT SC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 823 BELKNAP ST STE 106
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City | SUPERIOR
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State | WI
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Zip | 54880-2974
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Country | US
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Telephone | 218-310-4418
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Fax | 218-728-8554
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Provider Business Mailing Address
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Address Line | 1420 LONDON RD STE 100
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City | DULUTH
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State | MN
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Zip | 55805-2437
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Country | US
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Telephone | 218-310-4418
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Fax | 218-728-8554
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER MICHAEL DAVIES
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Credential | MD
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Telephone | 218-310-4418
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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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