Organization Name: | PRECISION PAIN & REHABILITATION SPECIALISTS PA |
NPI Number: | 1003135294 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY CONLY (PRESIDENT) |
Mailing Address: | 18958 Coastal Hwy Suite 1 Rehoboth Beach |
State: | DE US |
Postal Code: | 199716196 |
Phone Number: | 3028272323 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2010 |
NPI Last Update Date: | 12/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP3300X |
License Number: | 10-92131-05-000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Pain |
Taxonomy Definition: |