Organization
ADVANCED PAIN MEDICINE PC
Active
Other names
Advanced Pain Medicine Moon
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LODICO (MEDICAL DIRECTOR)
(724) 933-0300
Entity
Organization
Contact information
Practice address
1009 BEAVER GRADE RD, STE 100, MOON TWP, PA 15108-2969
(724) 933-0300
(724) 933-0456
Mailing address
7000 STONEWOOD DR, STE 151, WEXFORD, PA 15090-7376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077653000002
—
PA
Enumeration date
04/10/2012
Last updated
08/24/2022
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