Organization
BACK PAIN CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELE YVETTE HOLDING MD (PRESIDENT)
(610) 495-8416
Entity
Organization
Contact information
Practice address
100 1ST AVE, PHOENIXVILLE, PA 19460-3700
(610) 495-8416
Mailing address
PO BOX 222, SPRING CITY, PA 19475-0222
(610) 495-8416
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD051973-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0730718000
KEYSTONE EAST
PA
01
—
3770872
AETNA
PA
01
—
510594
BLUE CROSS BLUE SHIELD
PA
Enumeration date
05/27/2008
Last updated
12/04/2008
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