# PRO PAIN LLC

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

## Provider details

- **NPI number:** 1649735879
- **Authorized official:** MICHAEL SCOTT BOEDEFELD (OWNER)
- **Authorized official phone:** (636) 442-5035

## Contact information

- **Practice address:** 4800 MEXICO RD STE 101, SAINT PETERS, MO 63376-1666
- **Practice address phone:** (636) 442-5035
- **Mailing address:** 4800 MEXICO RD STE 101, SAINT PETERS, MO 63376-1666
- **Mailing address phone:** (636) 442-5035

## Taxonomy

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

## Other

- **Enumeration date:** 02/01/2019
- **Last updated:** 02/01/2019