Interventional Pain & Physical Medicine Clinic

LBN: Interventional Pain & Physical Medicine Clinic
Interventional Pain & Physical Medicine Clinic is an health care organization with primary practice located at 2301 Connecticut Avenue South , Sartell MN 56377-2474. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Ambulatory Health Care Facilities / Physical Therapy, Ambulatory Health Care Facilities / Pain. Ambulatory Health Care Facilities / Pain is the primary health care specialty. Interventional Pain & Physical Medicine Clinic can be contacted via phone (320) 229-1500, or through Kowalkowski, Stacy via phone (320) 229-1500.

Contact Information

Primary practice address
2301 Connecticut Avenue South Sartell MN 56377-2474
Phone: (320) 229-1500
Fax: (320) 229-1505
Website:
Map and Directions
Authorized official contact:
Name: Kowalkowski, Stacy Registered Nurse (RN)
Phone: (320) 229-1500

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 41961 Minnesota
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 41961 Minnesota
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 41961 Minnesota
Ambulatory Health Care Facilities / Pain 261QP3300X 41961 Minnesota

Profile Details

NPI number 1013056969
LBN Legal business name Interventional Pain & Physical Medicine Clinic
DBA Doing business as
Authorized official Kowalkowski, Stacy Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2007
Last updated Jul 14th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013056969 NPPES
Minnesota MEDICAID 410645800
Minnesota Other C03449

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