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General NPI Number Information
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NPI Number | 1902159809
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN CARE, PC
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 638 N MAIN ST SUITE A
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City | ASHLAND
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State | OR
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Zip | 97520-1887
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Country | US
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Telephone | 541-482-1712
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Fax | 541-482-1777
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Provider Business Mailing Address
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Address Line | 638 N MAIN ST SUITE A
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City | ASHLAND
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State | OR
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Zip | 97520-1887
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Country | US
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Telephone | 541-482-1712
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Fax | 541-482-1777
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARY D WERNER
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Credential |
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Telephone | 541-482-1712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD18140
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License Number State | OR
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