| Organization Name: | DRUG FREE PAIN CENTER LLC |
| NPI Number: | 1093158230 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN GARDNER (MANAGING MEMBER) |
| Mailing Address: | 224 Chimney Corner Ln 1026 Jupiter |
| State: | FL US |
| Postal Code: | 334584800 |
| Phone Number: | 5614449805 |
| Fax Number: | |
| NPI Enumeration Date: | 04/08/2013 |
| NPI Last Update Date: | 04/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME84984 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |