Organization
CENTERS FOR PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G THOR THORDARSON (CEO)
(219) 326-2555
Entity
Organization
Contact information
Practice address
1101 GLENDALE BLVD, VALPARAISO, IN 46383-3767
(219) 476-7246
Mailing address
1101 GLENDALE BLVD, VALPARAISO, IN 46383-3767
(219) 476-7246
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/09/2010
Last updated
05/14/2010
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