BRIGHTWAVE PAIN THERAPY PC NPI 1962062703

NPI Information

NPI: 1962062703
Provider Name: BRIGHTWAVE PAIN THERAPY, PC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
751 KENMOOR AVE SE
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 608-5551
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BRIGHTWAVE PAIN THERAPY, PC is a pain clinic center in Grand Rapids, MI. BRIGHTWAVE PAIN THERAPY, PC NPI is 1962062703. The provider is registered as an organization entity type.

The provider's business location address is:

751 KENMOOR AVE SE
GRAND RAPIDS, MI
ZIP 49546-388
Phone: (616) 608-5551

The provider's authorized official is Donald E Willman .
The authorized official title is President and has the following contact phone number (616) 608-5551.

The enumeration date for this NPI number is 6/14/2019 and was last updated on 6/14/2019.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP3300X	Clinic/Center	Pain			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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