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Organization

PAIN INJURY AND BRAIN CENTERS OF AMERICA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HAL KENNER CRNA (CLINICIAN)
(507) 410-1144
Entity
Organization

Contact information

Practice address
4465 HIGHWAY 61, GOODVIEW, MN 55987-1659
(507) 410-1144
(507) 410-1144
Mailing address
4465 HIGHWAY 61, GOODVIEW, MN 55987-1659
(507) 410-1144
(507) 410-1144

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R134470-7
MN

Other

Enumeration date
08/20/2011
Last updated
08/20/2011
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