# PAIN TREATMENT CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295827665
- **Authorized official:** DR. JOHN DAVID GRAHAM MD (OWNER PRESIDENT)
- **Authorized official phone:** (314) 872-5601

## Contact information

- **Practice address:** 2821 N BALLAS RD, SUITE C-11, SAINT LOUIS, MO 63131-2321
- **Practice address phone:** (314) 872-5601
- **Practice address fax:** (314) 872-5628
- **Mailing address:** PO BOX 953010, ST LOUIS, MO 63195-3010
- **Mailing address phone:** (314) 872-5601
- **Mailing address fax:** (314) 872-5628

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 036092540 | IL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 109904 | MO | Yes |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 04/05/2010