Provider Demographics
NPI:1124567227
Name:XPRESS PAIN CENTER, P.A.
Entity Type:Organization
Organization Name:XPRESS PAIN CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-340-3546
Mailing Address - Street 1:441 UNIVERSITY AVE W
Mailing Address - Street 2:201
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2085
Mailing Address - Country:US
Mailing Address - Phone:651-340-3546
Mailing Address - Fax:
Practice Address - Street 1:441 UNIVERSITY AVE W
Practice Address - Street 2:201
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2085
Practice Address - Country:US
Practice Address - Phone:651-340-3546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19164261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty