Provider Demographics
NPI:1558083444
Name:MIDWEST PAIN RELIEF CENTER, LLC
Entity Type:Organization
Organization Name:MIDWEST PAIN RELIEF CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-217-1252
Mailing Address - Street 1:1405 N ARGONIA RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KS
Mailing Address - Zip Code:67106-8016
Mailing Address - Country:US
Mailing Address - Phone:620-478-2878
Mailing Address - Fax:620-478-2360
Practice Address - Street 1:1405 N ARGONIA RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:KS
Practice Address - Zip Code:67106-8016
Practice Address - Country:US
Practice Address - Phone:620-478-2878
Practice Address - Fax:620-478-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty