Provider Demographics
NPI:1639460983
Name:PAIN CARE LLC
Entity Type:Organization
Organization Name:PAIN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-583-8800
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52004-0631
Mailing Address - Country:US
Mailing Address - Phone:563-583-8800
Mailing Address - Fax:563-583-8820
Practice Address - Street 1:2436 MEINEN CT
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2787
Practice Address - Country:US
Practice Address - Phone:563-583-8800
Practice Address - Fax:563-583-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty