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General NPI Number Information
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NPI Number | 1326617846
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Entity Type | Organization
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Legal Business Name | CHOICE PAIN & REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 06/19/2021
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 1001 PINE HEIGHTS AVE STE 200
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City | BALTIMORE
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State | MD
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Zip | 21229-5284
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Country | US
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Telephone | 240-786-1001
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Fax | 240-786-1002
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Provider Business Mailing Address
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Address Line | 8843 GREENBELT RD STE 117
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City | GREENBELT
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State | MD
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Zip | 20770-2451
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Country | US
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Telephone | 240-786-1001
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Fax | 240-786-1002
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | KELLI DEANNA GREGORY
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Credential |
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Telephone | 443-542-3529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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