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Organization
NORTHERN KENTUCKY PAIN RELIEF PHYSICAL MEDICINE CENTER PSC
Active
Organization
NORTHERN KENTUCKY PAIN RELIEF PHYSICAL MEDICINE CENTER PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD M DAMMEL MD (OWNER)
(513) 404-6983
Entity
Organization
Contact information
Practice address
7560 US HWY 42, FLORENCE, KY 41042-1469
(859) 283-2475
(859) 283-0097
Mailing address
7560 US HWY 42, FLORENCE, KY 41042-1469
(859) 283-2475
(859) 283-0097
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6682330001
MEDICARE DME SUPPLIER
KY
05
—
710021850
—
KY
05
—
7100439820
—
KY
05
—
7100439880
—
KY
Enumeration date
10/04/2011
Last updated
12/03/2018
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