Provider Demographics
NPI:1083844013
Name:INTERNATIONAL PAIN & REHABILITATION CENTER,LLC
Entity Type:Organization
Organization Name:INTERNATIONAL PAIN & REHABILITATION CENTER,LLC
Other - Org Name:IPARC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-418-1789
Mailing Address - Street 1:99 N BRICE RD
Mailing Address - Street 2:STE 240
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6510
Mailing Address - Country:US
Mailing Address - Phone:614-418-1789
Mailing Address - Fax:614-418-1790
Practice Address - Street 1:99 N BRICE RD
Practice Address - Street 2:STE 240
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-6510
Practice Address - Country:US
Practice Address - Phone:614-418-1789
Practice Address - Fax:614-418-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty