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General NPI Number Information
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NPI Number | 1831494434
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Entity Type | Organization
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Legal Business Name | SOLA PAIN CENTERS, LLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 08/29/2011
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Provider Practice Location Address
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Address Line | 1650 GRETNA BLVD STE 8
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City | HARVEY
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State | LA
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Zip | 70058-5426
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Country | US
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Telephone | 504-361-9080
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Fax | 504-361-0706
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Provider Business Mailing Address
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Address Line | 1650 GRETNA BLVD STE 8
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City | HARVEY
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State | LA
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Zip | 70058-5426
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Country | US
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Telephone | 504-361-9080
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Fax | 504-361-0706
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Authorized Official
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Title or Position | OWNER
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Name | CIRO CERRATO
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Credential |
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Telephone | 504-361-9080
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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