Basic Information
| Provider Information | |||||||||
| NPI: | 1134218068 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEHIGH VALLEY PAIN MANAGEMENT | ||||||||
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| OtherOrganizationName: | HORIZON OPEN MRI | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4825 TILGHMAN STREET | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103663900 | ||||||||
| FaxNumber: | 6103669229 | ||||||||
| Practice Location | |||||||||
| Address1: | 2211 QUARRY DR | ||||||||
| Address2: | |||||||||
| City: | READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103669000 | ||||||||
| FaxNumber: | 6103669229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BEERS | ||||||||
| AuthorizedOfficialFirstName: | SHERRY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6103669000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471M1202X | Y | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Magnetic Resonance Imaging |
No ID Information.