Organization Name: | MEDICAL ADVANCED PAIN SPECIALISTS, PA |
NPI Number: | 1003159567 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARSHA JEAN THIEL (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 7390 France Ave S Edina |
State: | MN US |
Postal Code: | 554354500 |
Phone Number: | 7635376000 |
Fax Number: | 7635376666 |
NPI Enumeration Date: | 04/03/2013 |
NPI Last Update Date: | 04/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP3300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Pain |
Taxonomy Definition: |