# KENOSHA PAIN CENTER LLC

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

## Provider details

- **NPI number:** 1508448853
- **Authorized official:** MS. KAREN M BEWER RN BSN (ADMINISTRATOR)
- **Authorized official phone:** (262) 297-7246

## Contact information

- **Practice address:** 6123 GREEN BAY RD STE 100, KENOSHA, WI 53142-2939
- **Practice address phone:** (262) 297-7246
- **Mailing address:** 2500 W LAYTON AVE STE 200, MILWAUKEE, WI 53221-5434
- **Mailing address phone:** (262) 297-7246

## Taxonomy

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

## Other

- **Enumeration date:** 04/26/2021
- **Last updated:** 05/04/2021