Basic Information
| Provider Information | |||||||||
| NPI: | 1316475957 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED PAIN RELIEF CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2976 N SCATTERFIELD RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
| FaxNumber: | 7656220126 | ||||||||
| Practice Location | |||||||||
| Address1: | 2976 N SCATTERFIELD RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
| FaxNumber: | 7656220126 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2017 | ||||||||
| LastUpdateDate: | 11/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | LUSHINSKY | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7656438781 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | N | Laboratories | Clinical Medical Laboratory | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 111N00000X | 08001691A | IN | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.