MEDICARE: PAIN RELIEF AND WELLNESS STRATEGIES CENTER PC

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
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1568816627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN RELIEF AND WELLNESS STRATEGIES CENTER PC

Provider Business Mailing Address
First Line	:	190 GEORGE JUNIOR RD
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-4414
Country	:	US
Telephone Number	:	724-458-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 GEORGE JUNIOR RD
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-4414
Country	:	US
Telephone Number	:	724-458-1100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KENNETH VINTON
Credential	:
Telephone Number	:	724-458-1100

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/14/2016

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