Provider Demographics
NPI:1790112183
Name:ADVANCED PAIN SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:ADVANCED PAIN SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-841-2615
Mailing Address - Street 1:431 SWARTZ CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-2161
Mailing Address - Country:US
Mailing Address - Phone:616-841-2615
Mailing Address - Fax:616-828-1752
Practice Address - Street 1:431 SWARTZ CT
Practice Address - Street 2:SUITE 200
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-2161
Practice Address - Country:US
Practice Address - Phone:616-841-2615
Practice Address - Fax:616-828-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092147261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain