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Organization
PAIN TREATMENT CENTERS OF GEORGIA LLC
Active
Organization
PAIN TREATMENT CENTERS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VADIM PETROV-KONDRATOV MD (PHYSICIAN OWNER)
(912) 910-3777
Entity
Organization
Contact information
Practice address
1907 SUNSET BLVD, JESUP, GA 31545-7813
(912) 910-3777
Mailing address
604 W OGLETHORPE HWY, HINESVILLE, GA 31313-4415
(912) 910-3777
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
06/17/2024
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