# PAIN, SPINE & REHAB.,A.S.C.,P.A.

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

## Provider details

- **NPI number:** 1720332810
- **Authorized official:** DR. BELL MANANIRINA RAZAFINDRABE M.D. (RESIDENT AGENT)
- **Authorized official phone:** (620) 792-2991

## Contact information

- **Practice address:** 925 S PATTON RD, SUITE B, GREAT BEND, KS 67530-4627
- **Practice address phone:** (620) 792-2991
- **Practice address fax:** (620) 792-3804
- **Mailing address:** 925 S PATTON RD, SUITE B, GREAT BEND, KS 67530-4627
- **Mailing address phone:** (620) 792-2991
- **Mailing address fax:** (620) 792-3804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0431344 | KS | Yes |

## Other

- **Enumeration date:** 10/29/2012
- **Last updated:** 10/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200354350C | — | KS |
