Pain Centers of Wisconsin - Beaver Dam, LLC
NPI #1356904254 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1356904254
- Entity Type
- Organization
- Organization Name
- Pain Centers of Wisconsin - Beaver Dam, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- APM WISCONSIN MSO, LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Apr 16, 2019
- Last Updated
- Apr 16, 2019
Practice Location
- Address
- 1701 N SPRING ST
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-1178
- Phone
- (414) 325-7246
Authorized Official
- Name
- VISHAL LAL
- Title
- AUTHORIZED REPRESENTATIVE
- Phone
- (414) 325-7246
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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