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Organization
PAIN MANAGMENT JOINT VENTURE LLP
Active
Organization
PAIN MANAGMENT JOINT VENTURE LLP
Active
Other names
Centre Of Rehabilitation Excellence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A LORREN PT (MANAGING PARTNER)
(903) 753-6635
Entity
Organization
Contact information
Practice address
3202 N 4TH ST, SUITE 101, LONGVIEW, TX 75605-5143
(903) 753-6635
(903) 236-3185
Mailing address
3202 N 4TH ST, SUITE 101, LONGVIEW, TX 75605-5143
(903) 753-6635
(903) 236-3185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5500600000
TX
225100000X
Physical Therapist
650460000
TX
225X00000X
Occupational Therapist
5500600000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071BT
BLUE CROSS
TX
05
—
021731701
—
TX
Enumeration date
05/27/2006
Last updated
12/02/2008
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