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General NPI Number Information
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NPI Number | 1558182972
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF SPECIALISTS
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 9811 MALLARD DR
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City | LAUREL
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State | MD
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Zip | 20708-3143
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Country | US
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Telephone | 443-978-8564
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Fax |
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Provider Business Mailing Address
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Address Line | 9811 MALLARD DR
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City | LAUREL
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State | MD
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Zip | 20708-3143
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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 | EXECUTIVE DIRECTOR
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Name | GLORIA CORBIN
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Credential |
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Telephone | 301-682-2047
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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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