Provider Demographics
NPI:1770893943
Name:THE CENTER FOR PHYSICAL MEDICINE AND PAIN MANAGEMENT PC
Entity type:Organization
Organization Name:THE CENTER FOR PHYSICAL MEDICINE AND PAIN MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:JANUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-260-8988
Mailing Address - Street 1:2227 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3439
Mailing Address - Country:US
Mailing Address - Phone:334-260-8988
Mailing Address - Fax:
Practice Address - Street 1:2227 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3439
Practice Address - Country:US
Practice Address - Phone:334-260-8988
Practice Address - Fax:334-260-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO4892081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000031366Medicare PIN