Provider Demographics
NPI:1639350168
Name:ACCIDENT & INJURY PAIN CENTER INC.
Entity Type:Organization
Organization Name:ACCIDENT & INJURY PAIN CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:PIASECKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:419-478-8600
Mailing Address - Street 1:602 W SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1984
Mailing Address - Country:US
Mailing Address - Phone:419-478-8600
Mailing Address - Fax:419-478-1288
Practice Address - Street 1:602 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1984
Practice Address - Country:US
Practice Address - Phone:419-478-8600
Practice Address - Fax:419-478-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N0000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty