Provider Demographics
NPI:1154469971
Name:PAIN SOLUTIONS NETWORK
Entity Type:Organization
Organization Name:PAIN SOLUTIONS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MERRITT
Authorized Official - Middle Name:S
Authorized Official - Last Name:OLESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-671-7246
Mailing Address - Street 1:416 ALTAVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2701
Mailing Address - Country:US
Mailing Address - Phone:513-671-7246
Mailing Address - Fax:513-671-4786
Practice Address - Street 1:1327 E KEMPER RD STE 3100B
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3945
Practice Address - Country:US
Practice Address - Phone:513-671-7246
Practice Address - Fax:513-671-4786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3319103G00000X
OHPT4825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherBWC
PA9358321Medicare ID - Type Unspecified