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General NPI Number Information
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NPI Number | 1003135294
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Entity Type | Organization
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Legal Business Name | PRECISION PAIN & REHABILITATION SPECIALISTS PA
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 18958 COASTAL HWY SUITE 1
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-6196
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Country | US
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Telephone | 302-827-2323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5316
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City | WILMINGTON
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State | DE
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Zip | 19808-0316
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY CONLY
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Credential | M.D.
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Telephone | 484-802-5943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 10-92131-05-000
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License Number State | DE
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