| Organization Name: | CHESTER PAIN MANAGEMENT |
| NPI Number: | 1649504986 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JARRED TELLER (OWNER) |
| Mailing Address: | 4610 Pennell Road Aston |
| State: | PA US |
| Postal Code: | 19014 |
| Phone Number: | 6104973722 |
| Fax Number: | 2672120020 |
| NPI Enumeration Date: | 09/18/2009 |
| NPI Last Update Date: | 09/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |