Organization
KEY PAIN MANAGEMENT AND TREATMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIMAL SHIV KUMAR M.D. (PRESIDENT)
(419) 625-6966
Entity
Organization
Contact information
Practice address
2800 HAYES AVE, BUILDING A, SANDUSKY, OH 44870-7248
(419) 625-6966
(419) 625-6997
Mailing address
PO BOX 1956, SANDUSKY, OH 44871-1956
(419) 625-6966
(419) 625-6997
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
58676
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061610
—
OH
Enumeration date
05/10/2007
Last updated
05/14/2014
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