Provider Demographics
NPI:1811558075
Name:KIRBY PAIN MANAGEMENT AND REHABILITATION
Entity Type:Organization
Organization Name:KIRBY PAIN MANAGEMENT AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-226-6399
Mailing Address - Street 1:55 GOSAI DR STE 112
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15314-1061
Mailing Address - Country:US
Mailing Address - Phone:412-226-6399
Mailing Address - Fax:724-239-2167
Practice Address - Street 1:55 GOSAI DR STE 112
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15314-1061
Practice Address - Country:US
Practice Address - Phone:412-226-6399
Practice Address - Fax:724-239-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty