Basic Information
| Provider Information | |||||||||
| NPI: | 1578962882 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPREHENSIVE PAIN SPECIALISTS, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4450 FASHION SQUARE BLVD | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486031251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892491922 | ||||||||
| FaxNumber: | 9892490227 | ||||||||
| Practice Location | |||||||||
| Address1: | 5154 MILLER RD | ||||||||
| Address2: | UNITS 3 & 4 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485071065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892491922 | ||||||||
| FaxNumber: | 9892490227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2014 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | PAPST | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9892491922 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 23D2080211 | MI | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | 23D2080211 | 01 | MI | CLIA ID NUMBER | OTHER |