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Organization

CLEVELAND BACK & PAIN MANAGEMENT CENTER INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN HARVEY NICKELS MD (DIRECTOR/ OFFICER)
(216) 687-4003
Entity
Organization

Contact information

Practice address
2307 W 14TH ST, CLEVELAND, OH 44113-3612
(216) 687-4003
(216) 687-4069
Mailing address
2307 W 14TH ST, CLEVELAND, OH 44113-3612
(216) 687-4003
(216) 687-4069

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35051581
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2802695
OH
Enumeration date
08/16/2006
Last updated
03/05/2012
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