Organization
PROFESSIONAL PAIN MANAGEMENT, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PURTOCK M.D. (PRESIDENT)
(262) 787-4026
Entity
Organization
Contact information
Practice address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(262) 787-4026
(262) 782-6040
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(262) 787-4026
(262) 782-6040
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
23846-20
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
23846-20
WI
208VP0014X
Interventional Pain Medicine Physician
23846
WI
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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