# NORTHERN LIGHTS PAIN MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1619203585
- **Authorized official:** DR. ROBERT VALENTZ MD (OWNER)
- **Authorized official phone:** (907) 770-9600

## Contact information

- **Practice address:** 1320 22ND AVE, FAIRBANKS, AK 99701-6516
- **Practice address phone:** (907) 452-4777
- **Practice address fax:** (907) 452-4787
- **Mailing address:** PO BOX 71434, FAIRBANKS, AK 99707-1434
- **Mailing address phone:** (907) 770-9600
- **Mailing address fax:** (907) 277-2629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 297874 | AK | Yes |

## Other

- **Enumeration date:** 10/27/2009
- **Last updated:** 10/27/2009