Organization
SV PAIN MANAGEMENT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THENU MANIKANTAN MD (PRESIDENT)
(413) 754-3793
Entity
Organization
Contact information
Practice address
171 DWIGHT RD, STE 102, LONGMEADOW, MA 01106-1673
(413) 754-3793
(413) 754-3467
Mailing address
171 DWIGHT RD, STE 102, LONGMEADOW, MA 01106-1673
(413) 754-3793
(413) 754-3467
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
209825
MA
Other
Enumeration date
07/16/2011
Last updated
10/23/2011
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