Organization
CORYDON PAIN MANAGEMENT CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE TORNATORE (OWNER)
(502) 767-9439
Entity
Organization
Contact information
Practice address
2230 EDSEL LN NW STE 1, CORYDON, IN 47112-2136
(812) 734-0303
(812) 225-5145
Mailing address
2230 EDSEL LN NW STE 1, CORYDON, IN 47112-2136
(812) 734-0303
(812) 225-5145
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
174400000X
Specialist
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201058650A
—
IN
Enumeration date
05/12/2011
Last updated
11/16/2021
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