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General NPI Number Information
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NPI Number | 1992304588
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Entity Type | Organization
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Legal Business Name | MIDWEST PAIN TREATMENT CENTER LLC
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 3005 S RIVERSIDE DR STE 201
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City | BELOIT
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State | WI
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Zip | 53511-1500
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Country | US
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Telephone | 608-365-6771
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Fax | 208-906-2390
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Provider Business Mailing Address
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Address Line | 3005 S RIVERSIDE DR STE 201
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City | BELOIT
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State | WI
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Zip | 53511-1500
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Country | US
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Telephone | 608-365-6771
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Fax | 208-906-2390
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Authorized Official
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Title or Position | MEMBER
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Name | LINDA M CHERF
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Credential | L.AC
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Telephone | 608-295-6186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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