# MONMOUTH COUNTY PAIN MANAGEMENT & WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1811319189
- **Authorized official:** NICOLE KEEGAN MD (MD)
- **Authorized official phone:** (908) 692-9833

## Contact information

- **Practice address:** 1131 BROAD ST STE 104, SHREWSBURY, NJ 07702-4334
- **Practice address phone:** (908) 692-9833
- **Mailing address:** 1131 BROAD ST STE 104, SHREWSBURY, NJ 07702-4334
- **Mailing address phone:** (908) 692-9833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 25MA08847600 | NJ | Yes |

## Other

- **Enumeration date:** 01/06/2014
- **Last updated:** 08/12/2014