Organization
PROFESSIONAL PHYSICIAN PAIN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH NEAL (COORDINATOR)
(405) 947-5557
Entity
Organization
Contact information
Practice address
114 PIPER HILL DR, SUITE 103, SAINT PETERS, MO 63376-1661
(636) 442-5035
(636) 442-5036
Mailing address
4400 WILL ROGERS PKWY, SUITE 105, OKLAHOMA CITY, OK 73108-1837
(405) 947-5557
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
2004009978
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
2006018031
MO
Other
Enumeration date
06/05/2009
Last updated
06/30/2009
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