Provider Demographics
NPI:1740592245
Name:INTEGRATED PAIN CONCEPTS LLC
Entity type:Organization
Organization Name:INTEGRATED PAIN CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA-WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-493-9550
Mailing Address - Street 1:PO BOX 26125
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-6125
Mailing Address - Country:US
Mailing Address - Phone:888-719-9015
Mailing Address - Fax:330-493-7123
Practice Address - Street 1:4172 HOLIDAY ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2532
Practice Address - Country:US
Practice Address - Phone:330-493-9550
Practice Address - Fax:330-493-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty