# ADVANCED PAIN, SPINE AND SPORTS MEDICINE, P.C.

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

## Provider details

- **NPI number:** 1699325688
- **Authorized official:** NICOLE RISPO (PRACTICE MANAGER)
- **Authorized official phone:** (570) 202-6671

## Contact information

- **Practice address:** 231 FRIEMANN LANE, SCIOTA, PA 18354
- **Practice address phone:** (570) 202-6671
- **Mailing address:** 231 FRIEMANN LANE, SCIOTA, PA 18354
- **Mailing address phone:** (570) 202-6671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2019
- **Last updated:** 09/13/2019