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General NPI Number Information
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NPI Number | 1669897724
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT ASSOCIATES OF NORTH CAROLINA
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 2270 HENDERSONVILLE RD
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City | ARDEN
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State | NC
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Zip | 28704-2753
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Country | US
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Telephone | 864-343-2643
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1254
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City | ARDEN
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State | NC
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Zip | 28704-1254
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Country | US
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Telephone | 864-343-2643
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRENADA NEIL
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Credential |
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Telephone | 864-343-2643
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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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