Provider Demographics
NPI:1902153109
Name:PAIN MANAGEMENT SERVICES INC.
Entity Type:Organization
Organization Name:PAIN MANAGEMENT SERVICES INC.
Other - Org Name:BRYANT ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-726-9000
Mailing Address - Street 1:3009 STRATOFORTRESS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5170
Mailing Address - Country:US
Mailing Address - Phone:209-726-9000
Mailing Address - Fax:209-669-6338
Practice Address - Street 1:3009 STRATOFORTRESS AVE STE B
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5170
Practice Address - Country:US
Practice Address - Phone:209-726-9000
Practice Address - Fax:209-669-6338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ23060ZMedicare PIN