Great River Pain Center LLC

NPI #1073865291 in Moline, Illinois

Provider Information

NPI Number: 1073865291
Entity Type: Organization
Organization Name: Great River Pain Center LLC
Primary Specialty: Pain Medicine - Pain Medicine
Enumeration Date: Oct 11, 2012
Last Updated: Oct 11, 2012

Practice Location

Address: 1634 AVENUE OF THE CITIES
City: Moline
State: Illinois
ZIP Code: 61265-4860
Phone: (309) 762-9711

Authorized Official

Name: DR. SANJAY SUNDAR, MD
Title: OWNER
Phone: (312) 613-9999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X	Primary

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