Organization
INTERVENTIONAL PAIN & ANESTHESIA CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYANT T ITTIARA D.O. (PRESIDENT)
(734) 604-0017
Entity
Organization
Contact information
Practice address
20100 OUTER DR, DEARBORN, MI 48124-2647
(734) 604-0017
Mailing address
416 JAMES CIR, ROYAL OAK, MI 48067-4545
(734) 604-0017
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
5101017919
MI
Other
Enumeration date
05/03/2016
Last updated
03/16/2017
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