Organization
OHIO VALLEY PAIN INTERVENTION LLC
Active
Organization
OHIO VALLEY PAIN INTERVENTION LLC
Active
Other names
Genesis Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN TYMCHAK DC (OWNER)
(812) 858-1008
Entity
Organization
Contact information
Practice address
8211 W STATE ROUTE 66, NEWBURGH, NEWBURGH, IN 47630-2534
(812) 858-1008
(812) 858-1001
Mailing address
8211 W STATE ROUTE 66, NEWBURGH, NEWBURGH, IN 47630-2534
(812) 858-1008
(812) 858-1001
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
IN
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
225100000X
Physical Therapist
05008961A
IN
363L00000X
Nurse Practitioner
71005174A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN1312
MEDICARE PTAN
IN
Enumeration date
04/25/2012
Last updated
07/07/2015
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