# PAIN CENTERS OF WISCONSIN - KENOSHA, LLC

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

## Provider details

- **NPI number:** 1407152945
- **Authorized official:** VISHAL LAL (CEO)
- **Authorized official phone:** (414) 325-7246

## Contact information

- **Practice address:** 9697 SAINT CATHERINES DR, STE 102, PLEASANT PRAIRIE, WI 53158-2118
- **Practice address phone:** (414) 325-7246
- **Mailing address:** 9697 SAINT CATHERINES DR, STE 102, PLEASANT PRAIRIE, WI 53158-2118
- **Mailing address phone:** (414) 325-7246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/01/2011
- **Last updated:** 10/24/2016