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General NPI Number Information
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NPI Number | 1811940182
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Entity Type | Organization
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Legal Business Name | PAIN EVALUATION & MANAGEMENT CENTER OF OHIO, INC.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 1550 YANKEE PARK PL STE A
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City | CENTERVILLE
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State | OH
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Zip | 45458-1838
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Country | US
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Telephone | 937-439-4949
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Fax | 937-439-4948
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Provider Business Mailing Address
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Address Line | DEPT L-2433
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City | COLUMBUS
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State | OH
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Zip | 43260-0001
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Country | US
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Telephone | 937-439-4949
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Fax | 937-439-4948
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. RICHARD MARTIN DONNINI
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Credential | D.O.
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Telephone | 937-439-4949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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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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