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General NPI Number Information
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NPI Number | 1912982125
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Entity Type | Organization
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Legal Business Name | METRO AREA PAIN CONSULTANTS, LTD
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 555 W COURT ST SUITE100
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City | KANKAKEE
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State | IL
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Zip | 60901-3664
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Country | US
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Telephone | 815-932-7246
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Fax | 815-932-7307
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Provider Business Mailing Address
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Address Line | PO BOX 723
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City | MUSKEGON
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State | MI
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Zip | 49443-0723
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Country | US
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Telephone | 231-780-6080
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Fax | 231-780-6090
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. STEPHANY SCOTT
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Credential |
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Telephone | 815-932-7246
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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 |
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License Number State |
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