Healthcare Provider Details
I. General information
NPI: 1942565361
Provider Name (Legal Business Name): PCA PAIN CARE CENTER OF CARY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2012
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 KEISLER DR SUITE B
CARY NC
27518-8801
US
IV. Provider business mailing address
200 KEISLER DR SUITE B
CARY NC
27518-8801
US
V. Phone/Fax
- Phone: 843-670-9598
- Fax:
- Phone: 843-670-9598
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
FOSTER
ROWE
Title or Position: OWNER
Credential: MD
Phone: 843-670-9598