Provider Demographics
NPI:1932823515
Name:PAIN THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:PAIN THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-331-2553
Mailing Address - Street 1:4 N DEER POINT RD STE 1001B
Mailing Address - Street 2:
Mailing Address - City:HAINESVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3814
Mailing Address - Country:US
Mailing Address - Phone:847-331-2553
Mailing Address - Fax:
Practice Address - Street 1:4 N DEER POINT RD STE 1001B
Practice Address - Street 2:
Practice Address - City:HAINESVILLE
Practice Address - State:IL
Practice Address - Zip Code:60030-3814
Practice Address - Country:US
Practice Address - Phone:847-331-2553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies