Organization
PAIN RELIEF 1 LLC
Active
Organization
PAIN RELIEF 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTYN BILLINGS (CREDENTIALING MANAGER)
(412) 655-4362
Entity
Organization
Contact information
Practice address
526 W WISCONSIN AVE, APPLETON, WI 54911-4382
(920) 427-8271
Mailing address
PO BOX 1274, APPLETON, WI 54912-1274
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55475
STATE LICENSE
WI
Enumeration date
06/10/2021
Last updated
06/10/2021
Update your record
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