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NPI Code Detail

MEDICARE: PAIN AND PERFORMANCE RELIEF LLC

MEDICARE: PAIN AND PERFORMANCE RELIEF LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1346597457
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN AND PERFORMANCE RELIEF LLC
Provider Business Mailing Address
First Line : PO BOX 790129
Second Line : DEPT 20067
City : SAINT LOUIS
State : MO
Zip : 63179-0129
Country : US
Telephone Number : 636-600-1137
Fax Number : 636-600-0412
Provider Business Practice Location Address
First Line : 4175 CRESCENT DR STE A
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129
Country : US
Telephone Number : 314-254-2400
Fax Number : 314-787-2141
Authorized Official
Title or Position : OWNER
Name : KEVIN J MEURET
Credential :
Telephone Number : 314-254-2420
Provider Enumeration Date : 08/08/2012
Last Update Date : 07/10/2018

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Directions to “PAIN AND PERFORMANCE RELIEF LLC ” Practice Location

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