Organization
PAIN MANAGEMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY R HECKER (CFO)
(330) 438-6352
Entity
Organization
Contact information
Practice address
229 W. MAIN CROSS ST, STE 58, FINDLAY, OH 45840
(419) 721-6358
(800) 261-0301
Mailing address
PO BOX 33792, DETROIT, MI 48232-3781
(800) 514-4390
(440) 808-3675
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107443
—
OH
05
—
1063831303
—
IL
05
—
1063831303
—
MI
05
—
7100363390
—
KY
Enumeration date
04/15/2014
Last updated
09/12/2022
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