Provider Demographics
NPI:1033224191
Name:ADVANCED PAIN MANAGEMENT CENTER, LLC
Entity Type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:JING
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-882-1434
Mailing Address - Street 1:598 OFFICE PKWY STE A
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8077
Mailing Address - Country:US
Mailing Address - Phone:614-882-1434
Mailing Address - Fax:614-882-1623
Practice Address - Street 1:598 OFFICE PKWY STE A
Practice Address - Street 2:SUITE B
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8077
Practice Address - Country:US
Practice Address - Phone:614-882-1434
Practice Address - Fax:614-882-1623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081375174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty