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General NPI Number Information
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NPI Number | 1225242399
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Entity Type | Organization
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Legal Business Name | EXPERT PAIN CLINIC LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3042 OAKCIFF RD SITE210
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City | DORAVILLE
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State | GA
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Zip | 30340
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Country | US
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Telephone | 770-452-4288
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Fax | 770-452-4289
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Provider Business Mailing Address
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Address Line | 3042 OAKCIFF RD SITE210
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City | DORAVILLE
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State | GA
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Zip | 30340
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Country | US
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Telephone | 770-452-4288
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Fax | 770-452-4289
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Authorized Official
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Title or Position | MEMBER
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Name | AHMAD GHADAMYARI
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Credential |
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Telephone | 770-452-4288
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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 | CHIR006529
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 032558
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License Number State | GA
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