Organization
DOWNTOWN PAIN MANAGEMENT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL LIBERMAN (OWNER)
(314) 588-8511
Entity
Organization
Contact information
Practice address
703 OLIVE ST, SUITE 211, SAINT LOUIS, MO 63101-2202
(314) 588-8511
Mailing address
703 OLIVE ST, SUITE 211, SAINT LOUIS, MO 63101-2202
(314) 588-8511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301089175
MO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301089175
MO
Other
Enumeration date
01/28/2009
Last updated
02/02/2009
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