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General NPI Number Information
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NPI Number | 1821966334
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Entity Type | Organization
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Legal Business Name | CENTRAL IOWA PAIN & WELLNESS LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 400 MAIN ST
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City | AMES
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State | IA
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Zip | 50010-6487
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Country | US
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Telephone | 515-468-2427
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MAIN ST
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City | AMES
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State | IA
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Zip | 50010-6487
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Country | US
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Telephone | 515-468-2427
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACOB MILLER
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Credential | ARNP
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Telephone | 785-608-7659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain 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 | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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