# VALLEY BACK & PAIN MANAGEMENT

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

## Provider details

- **NPI number:** 1417904319
- **Authorized official:** MARIE HENNIGAR (OFFICE MANAGER)
- **Authorized official phone:** (215) 947-7992

## Contact information

- **Practice address:** 1800 BYBERRY RD, SUITE 1101, HUNTINGDON VALLEY, PA 19006-3518
- **Practice address phone:** (215) 947-7992
- **Practice address fax:** (215) 947-7969
- **Mailing address:** 1800 BYBERRY RD, SUITE 1101, HUNTINGDON VALLEY, PA 19006-3518
- **Mailing address phone:** (215) 947-7992
- **Mailing address fax:** (215) 947-7969

## Taxonomy

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

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 08/16/2023