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General NPI Number Information
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NPI Number | 1700933066
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Entity Type | Organization
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Legal Business Name | PAIN SOLUTIONS INC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 223 STONERIDGE DRIVE
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City | COLUMBIA
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State | SC
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Zip | 29210-8009
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Country | US
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Telephone | 803-296-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 100 OLD CHEROKEE ROAD SUITE F, PMB 310
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City | LEXINGTON
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State | SC
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Zip | 29072-7959
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Country | US
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Telephone | 803-296-5990
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY S MASSEY
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Credential | PT
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Telephone | 803-920-6350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1095
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License Number State | SC
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