Provider Demographics
NPI:1356856389
Name:INTEGRATED PAIN SOLUTIONS LLC
Entity Type:Organization
Organization Name:INTEGRATED PAIN SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DRAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-569-2350
Mailing Address - Street 1:827 CORMIER RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-4706
Mailing Address - Country:US
Mailing Address - Phone:920-569-2350
Mailing Address - Fax:920-569-2333
Practice Address - Street 1:880 S VIEW DR STE 15230
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-8290
Practice Address - Country:US
Practice Address - Phone:844-200-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty