Organization
INTERVENTIONAL SPINE AND PAIN PHYSICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON S WOLFF (PARTNER)
(320) 253-3243
Entity
Organization
Contact information
Practice address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369
(763) 201-8191
(763) 201-8192
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-4466
(763) 201-8191
(763) 201-8192
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
09/14/2012
Last updated
05/10/2021
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