Healthcare Provider Details

I. General information

NPI: 1093870024
Provider Name (Legal Business Name): PRECISION PAIN MANAGEMENT CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 MARYLAND RD SUITE 200
WILLOW GROVE PA
19090-1704
US

IV. Provider business mailing address

600 LOUIS DR STE 202
WARMINSTER PA
18974-2847
US

V. Phone/Fax

Practice location:
  • Phone: 215-657-9393
  • Fax:
Mailing address:
  • Phone: 215-957-5400
  • Fax: 215-957-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD067744
License Number StatePA

VIII. Authorized Official

Name: BRIAN M BAYZICK
Title or Position: COO
Credential:
Phone: 215-657-9393