Provider Demographics
NPI:1871058339
Name:PREMIER PAIN TREATMENT INSTITUTE, LLC
Entity type:Organization
Organization Name:PREMIER PAIN TREATMENT INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:DANKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-454-7246
Mailing Address - Street 1:PO BOX 330
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-0330
Mailing Address - Country:US
Mailing Address - Phone:513-454-7246
Mailing Address - Fax:
Practice Address - Street 1:1301 MATTEC DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7300
Practice Address - Country:US
Practice Address - Phone:513-454-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER PAIN TREATMENT INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-08
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty