| Organization Name: | INTERVENTIONAL PAIN MANAGEMENT LLC |
| NPI Number: | 1083051346 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHETAN S. PURANIK (PRESIDENT) |
| Mailing Address: | 2205 Roosevelt Rd Valparaiso |
| State: | IN US |
| Postal Code: | 463832748 |
| Phone Number: | 2194767246 |
| Fax Number: | 2194761713 |
| NPI Enumeration Date: | 05/28/2013 |
| NPI Last Update Date: | 05/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |