Interventional Pain & Physical Medicine Clinic

NPI #1265784862 in Sartell, Minnesota

Provider Information

NPI Number: 1265784862
Entity Type: Organization
Organization Name: Interventional Pain & Physical Medicine Clinic
Primary Specialty: Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date: Oct 5, 2012
Last Updated: Oct 5, 2012

Practice Location

Address: 2301 CONNECTICUT AVE S
City: Sartell
State: Minnesota
ZIP Code: 56377-2474
Phone: (320) 229-1500

Authorized Official

Name: MRS. STACY KOWALKOWSKI, RN
Title: ADMINISTRATOR
Phone: (320) 229-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) — Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	Primary

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