Organization
INTERVENTIONAL PAIN CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJENDRA BOTHRA MD (OWNER)
(586) 757-4000
Entity
Organization
Contact information
Practice address
27423 VAN DYKE AVE, WARREN, MI 48093-2867
(586) 757-4000
(586) 755-9880
Mailing address
27423 VAN DYKE AVE, SUITE B, WARREN, MI 48093-2867
(586) 757-4000
(586) 755-9880
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2015
Last updated
02/20/2017
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