# PENINSULA PAIN RELIEF CENTER

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

## Provider details

- **NPI number:** 1497193650
- **Authorized official:** LARRY MIGGINS (PRESIDENT/OWNER)
- **Authorized official phone:** (360) 478-9788

## Contact information

- **Practice address:** 5050 STATE HIGHWAY 303 NE, SUITE A101, BREMERTON, WA 98311-3629
- **Practice address phone:** (360) 478-9788
- **Practice address fax:** (360) 405-6255
- **Mailing address:** 5050 STATE HIGHWAY 303 NE, SUITE A101, BREMERTON, WA 98311-3629
- **Mailing address phone:** (360) 478-9788
- **Mailing address fax:** (360) 405-6255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2013
- **Last updated:** 07/09/2013