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Organization

WELEVATE FOR PAIN A MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE DUFFIELD (CREDENTIALING)
(470) 473-4809
Entity
Organization

Contact information

Practice address
45210 CLUB DR, INDIAN WELLS, CA 92210-8860
(914) 758-0044
(914) 533-3568
Mailing address
45210 CLUB DR, INDIAN WELLS, CA 92210-8860

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
10/05/2021
Last updated
10/05/2021
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