PAIN CENTERS OF WISCONSIN - WAUSAU LLC NPI 1316206972

NPI Information

PAIN CENTERS OF WISCONSIN - WAUSAU, LLC is an ambulatory surgical clinic center in Wausau, WI. PAIN CENTERS OF WISCONSIN - WAUSAU, LLC NPI is 1316206972. The provider is registered as an organization entity type.

The provider's business location address is:

400 WESTWOOD DR
SUITE 200
WAUSAU, WI
ZIP 54401-801
Phone: (715) 261-0425
Fax: (715) 261-2450

The provider's authorized official is Vishal Lal .
The authorized official title is Chief Executive Officer and has the following contact phone number (414) 325-7246.

The CLIA number assigned to this NPI record is 24D2011713 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2012 and was last updated on 11/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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