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Organization

CMH PAIN MANAGEMENT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONNIE TATUM (CFO)
(952) 442-9770
Entity
Organization

Contact information

Practice address
125 BUENA VISTA CIR, SOUTH HILL, VA 23970-1431
(434) 447-3151
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Enumeration date
03/18/2008
Last updated
03/18/2008
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