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General NPI Number Information
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NPI Number | 1831438225
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Entity Type | Organization
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Legal Business Name | PHYSICIANS INTERVENTIONAL PAIN CENTER LLC
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 825 DAVIS ST #E
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City | BLACKSBURG
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State | VA
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Zip | 24060-7013
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Country | US
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Telephone | 540-953-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 745 OLD WILMINGTON RD
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City | HOCKESSIN
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State | DE
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Zip | 19707-9305
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Country | US
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Telephone | 302-521-9703
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. PAMELA WILLIS
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Credential |
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Telephone | 302-521-9703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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