Provider Demographics
NPI:1497426050
Name:COMPREHENSIVE PAIN AND SPINE SPECIALISTS LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN AND SPINE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TROBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-250-7973
Mailing Address - Street 1:3570 N BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5211
Mailing Address - Country:US
Mailing Address - Phone:765-213-6373
Mailing Address - Fax:
Practice Address - Street 1:3570 N BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4211
Practice Address - Country:US
Practice Address - Phone:765-213-6373
Practice Address - Fax:765-213-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty