Organization
MEDICAL PAIN MANAGEMENT SERVICES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN J. NEWMAN (DIRECTOR OF ACCOUNTING)
(815) 877-4848
Entity
Organization
Contact information
Practice address
1235 N MULFORD RD, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050
Mailing address
1235 N MULFORD RD, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
060-005593
IL
Other
Enumeration date
07/14/2006
Last updated
01/20/2016
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