Healthcare Provider Details

I. General information

NPI: 1396392197
Provider Name (Legal Business Name): CAROLINA PAIN RELIEF CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4146 MENDENHALL OAKS PKWY STE 105
HIGH POINT NC
27265-8034
US

IV. Provider business mailing address

2902 TURNER GROVE DR N
GREENSBORO NC
27455-1977
US

V. Phone/Fax

Practice location:
  • Phone: 336-740-9580
  • Fax: 336-790-4182
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRENESA HALL
Title or Position: OWNER
Credential: MD
Phone: 336-740-9580