Organization
COMPREHENSIVE PAIN AND SPINE SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ANN GRAVES (CREDENTIALING COORDINATOR)
(888) 732-4293
Entity
Organization
Contact information
Practice address
10744 E US HIGHWAY 36, AVON, IN 46123-7982
(765) 224-6513
(844) 440-2328
Mailing address
10744 E US HIGHWAY 36, AVON, IN 46123-7982
(765) 224-6513
(844) 440-2328
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300067686
—
IN
Enumeration date
03/01/2023
Last updated
03/01/2023
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