Provider Demographics
NPI:1770855314
Name:NEUROPATHY RELIEF CENTERS INC
Entity Type:Organization
Organization Name:NEUROPATHY RELIEF CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BODRE
Authorized Official - Middle Name:MACK
Authorized Official - Last Name:RISING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-289-1411
Mailing Address - Street 1:1948 MESQUITE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5777
Mailing Address - Country:US
Mailing Address - Phone:928-846-3620
Mailing Address - Fax:866-611-9440
Practice Address - Street 1:1948 MESQUITE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5777
Practice Address - Country:US
Practice Address - Phone:928-846-3620
Practice Address - Fax:866-611-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty