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Organization
SOUTHERN PAIN INSTITUTE P C
Active
Organization
SOUTHERN PAIN INSTITUTE P C
Active
Other names
Southern Pain Institute
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN CLAVO (PIC)
(770) 632-3730
Entity
Organization
Contact information
Practice address
1501 MILSTEAD RD NE STE 140, CONYERS, GA 30012-3849
(770) 632-3730
(770) 632-3731
Mailing address
1975 HIGHWAY 54 W, STE 100, PEACHTREE CITY, GA 30269-4794
(770) 313-3380
(770) 632-3731
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009658
GA
Other
Enumeration date
07/22/2010
Last updated
02/24/2015
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