Organization
ADVANCED PAIN MANAGEMENT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S WILLENS D.O. (PRESIDENT)
(904) 635-5555
Entity
Organization
Contact information
Practice address
5757 BOOTH ROAD, BLDG 100, JACKSONVILLE, FL 32207
(904) 683-2596
(904) 683-2597
Mailing address
5757 BOOTH ROAD, BLDG 100, JACKSONVILLE, FL 32207
(904) 683-2596
(904) 683-2597
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS8432
FL
Other
Enumeration date
08/11/2009
Last updated
07/26/2010
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