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NPI Code Detail

MEDICARE: PAIN MANAGEMENT & REHABILITATION SPECIALISTS, PC

MEDICARE: PAIN MANAGEMENT & REHABILITATION SPECIALISTS, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1437176419
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN MANAGEMENT & REHABILITATION SPECIALISTS, PC
Provider Business Mailing Address
First Line : 4409 EVANS TO LOCKS RD
Second Line :
City : EVANS
State : GA
Zip : 30809-3603
Country : US
Telephone Number : 706-396-7671
Fax Number : 706-396-7676
Provider Business Practice Location Address
First Line : 4409 EVANS TO LOCKS RD
Second Line :
City : EVANS
State : GA
Zip : 30809-3603
Country : US
Telephone Number : 706-396-7671
Fax Number : 706-396-7676
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. KRISTEN B COVINGTON
Credential :
Telephone Number : 706-396-7671
Provider Enumeration Date : 07/16/2006
Last Update Date : 03/26/2024

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Directions to “PAIN MANAGEMENT & REHABILITATION SPECIALISTS, PC ” Practice Location

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