INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC; NPI #1265784862

Contact Information

INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC

2301 CONNECTICUT AVE S
SARTELL, MN 56377-2474

Phone: 320-229-1500
Fax: 320-229-1505
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC

NPI Number	`1265784862`
LBN Legal business name	INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC
Authorized official	STACY KOWALKOWSKI - (ADMINISTRATOR)
Entity	Organization
Organization subpart ¹	No
Enumeration date	10/05/2012
Last updated	10/05/2012 - About 14 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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