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Organization
PB MEDICAL GROUP LLC
Active
Organization
PB MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN DAVIS WALLACE MBR (CO-FOUNDER AND CEO)
(561) 255-4135
Entity
Organization
Contact information
Practice address
2290 10TH AVE N STE 201, LAKE WORTH, FL 33461-6609
(561) 225-2890
Mailing address
2290 10TH AVE N STE 201, LAKE WORTH, FL 33461-6609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/25/2015
Last updated
09/28/2015
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