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Organization
INTERVENTIONAL PAIN GROUP PA
Active
Organization
INTERVENTIONAL PAIN GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKKI LEIGH GAMBRILL CRNA (PRESIDENT)
(913) 717-0177
Entity
Organization
Contact information
Practice address
1004 PROGRESS DR STE 170, LANSING, KS 66043-6323
(913) 828-0136
(913) 828-0296
Mailing address
PO BOX 269, LANSING, KS 66043-0269
(913) 828-0136
(913) 828-0296
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QP3300X
Pain Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
07/09/2020
Last updated
08/02/2022
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