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Organization
CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC INC
Active
Organization
CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA BEDOYA (CREDENTIALING SPECIALIST)
(813) 448-3848
Entity
Organization
Contact information
Practice address
1300 MABLE AVE # SUITEB2, MODESTO, CA 95355-1120
(813) 448-3848
Mailing address
311 PARK PLACE BLVD FL 5, CLEARWATER, FL 33759-4904
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A51949
CA
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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