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General NPI Number Information
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NPI Number | 1225309305
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Entity Type | Organization
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Legal Business Name | RELIABLE PAIN MANAGEMENT-HOLLYWOOD,INC
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 6495 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4110
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Country | US
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Telephone | 954-961-8760
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Fax |
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Provider Business Mailing Address
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Address Line | 6495 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4110
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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 | MANAGEMENT
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Name | MRS. KIM DAWSON
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Credential |
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Telephone | 954-961-8760
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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 |
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License Number State |
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