# INTEGRATIVE SPINE AND PAIN MANAGEMENT, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184863748
- **Authorized official:** DR. RICHARD JAY KOVAN M.D. (PHYSICIAN)
- **Authorized official phone:** (810) 606-7181

## Contact information

- **Practice address:** 12851 GRAND RIVER RD, BRIGHTON, MI 48116-8506
- **Practice address phone:** (810) 606-7181
- **Practice address fax:** (810) 606-7174
- **Mailing address:** 4632 GENESYS PKWY, GRAND BLANC, MI 48439-8067
- **Mailing address phone:** (810) 606-7181
- **Mailing address fax:** (810) 606-7174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/05/2009
- **Last updated:** 02/05/2009