Organization
KEY PAIN MANAGEMENT AND TREATMENT CENTER, INC
Active
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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