Provider Demographics
NPI:1740646660
Name:PAIN RELIEF TREATMENT CENTERS OF BLOOMINGDALE INC
Entity type:Organization
Organization Name:PAIN RELIEF TREATMENT CENTERS OF BLOOMINGDALE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-219-4152
Mailing Address - Street 1:290 SPRINGFIELD DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2214
Mailing Address - Country:US
Mailing Address - Phone:630-924-1111
Mailing Address - Fax:630-924-0841
Practice Address - Street 1:290 SPRINGFIELD DR
Practice Address - Street 2:SUITE 255
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2214
Practice Address - Country:US
Practice Address - Phone:630-924-1111
Practice Address - Fax:630-924-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty