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General NPI Number Information
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NPI Number | 1992644124
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Entity Type | Organization
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Legal Business Name | PAIN CENTER OF VIRGINIA, PLLC
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 19638 LEITERSBURG PIKE STE 204
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City | HAGERSTOWN
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State | MD
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Zip | 21742-1518
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Country | US
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Telephone | 240-850-3210
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Fax | 240-513-4536
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Provider Business Mailing Address
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Address Line | 19638 LEITERSBURG PIKE STE 204
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City | HAGERSTOWN
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State | MD
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Zip | 21742-1518
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Country | US
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Telephone | 240-850-3210
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Fax | 240-513-4536
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | JACQUELINE MARIE PENNINGTON
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Credential |
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Telephone | 304-263-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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