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1255609574
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
WOOD RIVER, IL
NPI
1255609574
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Entity Type
Organization
Authorized Contact
BUD CHOMHIRUN
Medical Director
618-259-3321
Organization Subpart ?
Yes
Primary Taxonomy
332900000X Non-Pharmacy Dispensing Site
Enumeration Date
2011-12-01
Last Update Date
2012-01-03
Business Address
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
1702 VAUGHN RD
WOOD RIVER, IL 62095-1898
Phone number: 618-259-3321
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Mailing Address
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
2980 N BEVERLY GLEN CIR SUITE 301
LOS ANGELES, CA 90077-1726
Phone number: 310-474-9809
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