Provider Demographics
NPI:1861832701
Name:THREE RIVERS PAIN AND ANESTHESIA ASSOCIATES PLLC
Entity Type:Organization
Organization Name:THREE RIVERS PAIN AND ANESTHESIA ASSOCIATES PLLC
Other - Org Name:TRISTATE PAIN AND SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-941-4626
Mailing Address - Street 1:109 MOUNT WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:
Practice Address - Street 1:160 GALLERY DR
Practice Address - Street 2:STE 200
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2690
Practice Address - Country:US
Practice Address - Phone:304-233-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439637208VP0000X
WV25058208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty