Provider Demographics
NPI:1134761612
Name:INDIANA PAIN AND INJURY CENTERS LLC
Entity type:Organization
Organization Name:INDIANA PAIN AND INJURY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-210-0794
Mailing Address - Street 1:5135 S EMERSON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-1967
Mailing Address - Country:US
Mailing Address - Phone:317-991-5710
Mailing Address - Fax:
Practice Address - Street 1:5135 S EMERSON AVE STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-1967
Practice Address - Country:US
Practice Address - Phone:317-991-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty