Provider Demographics
NPI:1760155899
Name:60 MINUTE PAIN CLINIC, LLC
Entity Type:Organization
Organization Name:60 MINUTE PAIN CLINIC, LLC
Other - Org Name:60 MINUTE PAIN CLINIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ONOFRIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-217-9355
Mailing Address - Street 1:6105 FATHER TRIBOU ST STE 4
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3027
Mailing Address - Country:US
Mailing Address - Phone:501-747-1320
Mailing Address - Fax:501-747-1321
Practice Address - Street 1:6105 FATHER TRIBOU ST STE 46105
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3027
Practice Address - Country:US
Practice Address - Phone:501-747-1320
Practice Address - Fax:501-747-1321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty