Haven Spine & Pain Center Pllc
Interventional Pain Medicine Physician in Grand Rapids, MI(View on Map)
Legal Business Name
Haven Spine & Pain Center Pllc
NPI Number
1053901314
NPI Type
Organization
Enumeration Date
01/21/2021
Specialties
(Taxonomies)Name
Code
208VP0014X
207LP2900X
208VP0000X
Primary Taxonomy
Yes
No
No
Contact
Information
Purpose
Mailing
Location
Address
2680 LEONARD ST NE STE 3
2680 LEONARD ST NE STE 3
City
Grand Rapids
Grand Rapids
State
MI
MI
Postal Code
49525-6902
49525-6902
Country
US
US
Telephone Number
(616) 364-4200
(616) 364-4200
Authorized Official
Name
Jack Dillon
Title or Position
EXECUTIVE DIRECTOR
Telephone Number
(312) 505-1033
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/09/2021