Provider Demographics
NPI:1932835394
Name:COMPREHENSIVE PAIN AND SPINE SPECIALISTS LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN AND SPINE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TROBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-213-6373
Mailing Address - Street 1:3570 N BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5211
Mailing Address - Country:US
Mailing Address - Phone:765-224-6513
Mailing Address - Fax:
Practice Address - Street 1:4725 STATESMEN DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-5644
Practice Address - Country:US
Practice Address - Phone:765-224-6513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies