DUBUQUE PAIN CLINIC
Psychiatric at Mercy Dr, Dubuque, IA

License number
Iowa 34875
Category
Psychiatric
Type
Pain Medicine
License number
Iowa 34875
Category
Psychiatric
Type
Interventional Pain Medicine
Owner
Name: IVAN FOMITCHEV MD
Title: PRESIDENT
Phone: (563) 564-1283
Address
Address
250 Mercy Dr, Dubuque, IA 52001
National Provider ID: 1467863472
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about DUBUQUE PAIN CLINIC at bizstanding.com

DUBUQUE PAIN CLINIC, LLC

2100 Asbury Rd SUITE 8, Dubuque, IA

Registration:
Dec 1, 2012
State ID:
446897
Business type:
DOMESTIC LIMITED LIABILITY COMPANY
Expiration:
PERPETUAL
Agent:
Ivan Fomitchev ,2260 Samantha Dr, Dubuque, IA (Physical)

Dubuque Pain Clinic LLC

2260 Samantha Dr, Dubuque, IA 52002

Industry:
Health and Allied Services, Nec, Nsk, Health/Allied Services
Principal:
Ivan Fomitchev (Principal)

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