Provider Demographics
NPI:1972963890
Name:NATURAL PAIN MANAGEMENT COMMUNITY ACUPUNCTURE LLC
Entity type:Organization
Organization Name:NATURAL PAIN MANAGEMENT COMMUNITY ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSCI, LAC
Authorized Official - Phone:608-322-4408
Mailing Address - Street 1:1 PARKER PL STE 301
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-4000
Mailing Address - Country:US
Mailing Address - Phone:608-322-4408
Mailing Address - Fax:
Practice Address - Street 1:1 PARKER PL STE 301
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-4000
Practice Address - Country:US
Practice Address - Phone:608-322-4408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI711-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty