NPI age
20 years
Enumerated 2005-09-13
Across 315 active pain medicine providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (WV) | 3004482000 | |
| 05 (KY) | 64055023 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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