Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michiana Spine, Sports & Occupational Rehab, PC

Organization Interventional Pain Medicine Physician · NPI 1407115884

Michiana Spine, Sports & Occupational Rehab, PC is an Interventional Pain Medicine Physician in Saint Joseph, Michigan. Licensed in Michigan. Registered with an NPI since 2012.

Licensed in
MI
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2500 Niles Rd Ste 3
Saint Joseph, MI 49085-3225
Phone: (574) 252-4150
Fax: (574) 252-4159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 4301070312 (MI)

Record details

NPI number1407115884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Drew — Owner · (574) 252-4150
NPI enumeratedMay 7, 2012
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3474