Organization
PAIN MANAGEMENT ASSOCIATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ANTHONY DEMANGONE M.D. (PRESIDENT)
(440) 944-1414
Entity
Organization
Contact information
Practice address
6025 COMMERCE CIR, #2, WILLOUGHBY, OH 44094-9668
(440) 944-1414
(440) 944-1445
Mailing address
6035 COMMERCE CIRCLE, #2, WILLOUGHBY, OH 44094
(440) 944-1414
(440) 944-1445
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
35071438D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3016640
—
OH
Enumeration date
10/11/2006
Last updated
08/18/2011
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