Provider Demographics
NPI:1679038384
Name:PREMIER PAIN TREATMENT INSTITUTE, LLC
Entity Type:Organization
Organization Name:PREMIER PAIN TREATMENT INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:DANKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-454-7246
Mailing Address - Street 1:PO BOX 35914
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1201
Mailing Address - Country:US
Mailing Address - Phone:888-488-8289
Mailing Address - Fax:
Practice Address - Street 1:1121 NORTHVIEW DR STE 2
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8206
Practice Address - Country:US
Practice Address - Phone:513-454-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER PAIN TREATMENT INSTITUTE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-06
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty