# VIRGINIA INNOVATIVE PAIN AND SPINE

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

## Provider details

- **NPI number:** 1568821221
- **Authorized official:** GENEAYE WAKEFIELD (OFFICE MANAGER)
- **Authorized official phone:** (804) 661-8616

## Contact information

- **Practice address:** 2532 MILL RD, POWHATAN, VA 23139-5203
- **Practice address phone:** (804) 335-0802
- **Practice address fax:** (804) 335-0802
- **Mailing address:** 2532 MILL RD, POWHATAN, VA 23139-5203

## Taxonomy

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

## Other

- **Enumeration date:** 02/23/2016
- **Last updated:** 02/23/2016