Provider Demographics
NPI:1073407037
Name:ALLEVIATE PAIN AND WELLNESS
Entity type:Organization
Organization Name:ALLEVIATE PAIN AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBURN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-619-1722
Mailing Address - Street 1:40 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2806
Mailing Address - Country:US
Mailing Address - Phone:203-619-1722
Mailing Address - Fax:
Practice Address - Street 1:850 N MAIN STREET EXT STE 3C
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2400
Practice Address - Country:US
Practice Address - Phone:203-619-1722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty