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General NPI Number Information
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NPI Number | 1093870024
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Entity Type | Organization
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Legal Business Name | PRECISION PAIN MANAGEMENT CENTER, P.C.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 2325 MARYLAND RD SUITE 200
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1704
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Country | US
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Telephone | 215-657-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 600 LOUIS DR STE 202
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City | WARMINSTER
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State | PA
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Zip | 18974-2847
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Country | US
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Telephone | 215-957-5400
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Fax | 215-957-5401
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Authorized Official
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Title or Position | COO
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Name | BRIAN M BAYZICK
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Credential |
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Telephone | 215-657-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD067744
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License Number State | PA
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