Organization
FW INTERVENTIONAL PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL COZZI MD (SOLE MEMBER)
(260) 672-8979
Entity
Organization
Contact information
Practice address
2510 E DUPONT RD, SUITE 115, FORT WAYNE, IN 46825-1600
(260) 672-8979
Mailing address
2510 E DUPONT RD, SUITE 115, FORT WAYNE, IN 46825-1600
(260) 672-8979
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01045203A
IN
Other
Enumeration date
11/27/2013
Last updated
02/18/2014
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