Healthcare Provider Details

I. General information

NPI: 1023513199
Provider Name (Legal Business Name): PAIN TREATMENT CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W PALMETTO ST
FLORENCE SC
29501-4427
US

IV. Provider business mailing address

505 W PALMETTO ST
FLORENCE SC
29501-4427
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-9500
  • Fax: 843-669-1054
Mailing address:
  • Phone: 843-669-9500
  • Fax: 843-669-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN D MCKAY
Title or Position: PRESIDENT
Credential: DC
Phone: 843-669-9500