Organization
ADVANCED SPINE & PAIN MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUKARRAM A KHAN DO (OWNER/PRESIDENT)
(937) 436-8370
Entity
Organization
Contact information
Practice address
450B WASHINGTON JACKSON RD, SUITE 106, EATON, OH 45320-7600
(937) 456-8370
(937) 456-8371
Mailing address
450B WASHINGTON JACKSON RD, SUITE 106, EATON, OH 45320-7600
(937) 456-8370
(937) 456-8371
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
OH
332B00000X
Durable Medical Equipment & Medical Supplies
—
OH
Other
Enumeration date
01/17/2014
Last updated
05/19/2014
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