OrganizationActive
Interventional Pain Center, PLLC.
NPI 1891137220 · Pain Medicine (Physical Medicine & Rehabilitation) Physician · Minnetonka, MN
Provider details
- NPI number
- 1891137220
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Ketroser, Owner(952) 236-7610
- License
- 24316 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Chiropractic Providers
Allopathic & Osteopathic Physicians
Practice location
10653 Wayzata Blvd
Suite 200
Minnetonka, MN 55305-1528
Phone: (952) 236-7610
Fax: (952) 426-0674
Approximate (ZIP-level) locationGet directions
Mailing address
10653 Wayzata Blvd
Minnetonka, MN 55305-1528
Registry dates
- Enumerated
- 2013-07-26
- Last updated
- 2014-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.