OrganizationActive
Haven Spine & Pain Center PLLC
NPI 1053901314 · Interventional Pain Medicine Physician · Grand Rapids, MI
Provider details
- NPI number
- 1053901314
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Jack Dillon, Executive Director
Practice location
2680 Leonard St Ne Ste 3
Grand Rapids, MI 49525-6902
Phone: (616) 364-4200
Fax: (616) 364-7347
Mailing address
2680 Leonard St Ne Ste 3
Grand Rapids, MI 49525-6902
Registry dates
- Enumerated
- 2021-01-21
- Last updated
- 2021-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.