# FOUR STATES PAIN RELIEF INSTITUTE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 4 Corners Pain Relief Institute, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033409198
- **Authorized official:** DR. JOHN KNUDSEN III MD (OWNER)
- **Authorized official phone:** (417) 624-4277

## Contact information

- **Practice address:** 2650 E 32ND ST, SUITE 101, JOPLIN, MO 64804-4313
- **Practice address phone:** (417) 624-4277
- **Practice address fax:** (417) 624-4297
- **Mailing address:** 1515 E 32ND ST, STE B, JOPLIN, MO 64804-2905
- **Mailing address phone:** (417) 624-4277
- **Mailing address fax:** (417) 624-4297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/11/2011
- **Last updated:** 08/08/2013