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General NPI Number Information
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NPI Number | 1386029023
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Entity Type | Organization
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Legal Business Name | ASSOCIATES COMPREHENSIVE PAIN MANAGEMENT CLINIC PLLC
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 29193 NORTHWESTERN HWY SUITE 571
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 202-607-1302
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Fax |
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Provider Business Mailing Address
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Address Line | 29193 NORTHWESTERN HWY SUITE 571
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 202-607-1302
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | DR. GARRETT SMITH
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Credential | M.D.
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Telephone | 202-491-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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