Healthcare Provider Details
I. General information
NPI: 1568250298
Provider Name (Legal Business Name): PAIN RELIEF THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2375 COULEE CROSSING RD
WOODWORTH LA
71485-9713
US
IV. Provider business mailing address
2375 COULEE CROSSING RD
WOODWORTH LA
71485-9713
US
V. Phone/Fax
- Phone: 318-715-7155
- Fax:
- Phone: 318-715-7155
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0000X |
| Taxonomy | Pain Management Registered Nurse |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
MICHOT
Title or Position: OWNER
Credential: RN
Phone: 318-715-7155