# KENTUCKY INTERVENTIONAL SPINE

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

## Provider details

- **NPI number:** 1407006760
- **Authorized official:** RICK PELLANT DO (SOLE OWNER)
- **Authorized official phone:** (859) 238-7746

## Contact information

- **Practice address:** 236 W MAIN ST, SUITE 203, DANVILLE, KY 40422-1876
- **Practice address phone:** (859) 238-7746
- **Mailing address:** 236 W MAIN ST, SUITE 203, DANVILLE, KY 40422-1876
- **Mailing address phone:** (859) 238-7746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | TP236 | KY | Yes |

## Other

- **Enumeration date:** 09/23/2008
- **Last updated:** 12/14/2011