Organization
ADVANCED PAIN INTERVENTION SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED P ROSCHE M.D., DABPM (OWNER)
(815) 387-1012
Entity
Organization
Contact information
Practice address
534 ROXBURY RD, ROCKFORD, IL 61107-5076
(815) 387-1012
(815) 381-0776
Mailing address
PO BOX 109, ROSCOE, IL 61073-0109
(815) 387-1012
(815) 381-0776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036097335
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097335
—
IL
Enumeration date
09/21/2006
Last updated
03/23/2011
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