Organization Name: | PRIMARY CARE AND PAIN MANAGEMENT CLINIC LLC |
NPI Number: | 1215328497 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MILA VELUZ (REGISTERED NURSE) |
Mailing Address: | 5415 Beacon Dr Suite 163 Irondale |
State: | AL US |
Postal Code: | 352102860 |
Phone Number: | 2059568767 |
Fax Number: | |
NPI Enumeration Date: | 02/10/2015 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP3300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Pain |
Taxonomy Definition: |