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General NPI Number Information
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NPI Number | 1750304002
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Entity Type | Organization
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Legal Business Name | CAROLINAS CENTER FOR ADVANCED MANAGEMENT OF PAIN, LLC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 279 E KENNEDY ST
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City | SPARTANBURG
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State | SC
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Zip | 29302-1912
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Country | US
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Telephone | 864-583-0053
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Fax | 864-583-0390
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Provider Business Mailing Address
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Address Line | PO BOX 6130
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City | SPARTANBURG
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State | SC
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Zip | 29304-6130
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Country | US
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Telephone | 864-583-0053
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Fax | 864-583-0390
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Authorized Official
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Title or Position | OWNER/MD
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Name | DR. JOHN HAASIS
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Credential |
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Telephone | 864-583-0053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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