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Organization
ATLANTIC COAST PAIN SPECIALISTS, INC
Active
Organization
ATLANTIC COAST PAIN SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BLAKE KLINE MD (OWNER)
(843) 438-8470
Entity
Organization
Contact information
Practice address
2767 CULTRA RD, CONWAY, SC 29526-3716
(843) 438-8470
(843) 438-8480
Mailing address
2767 CULTRA RD, CONWAY, SC 29526-3716
(843) 438-8470
(843) 438-8480
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
20364
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
03/04/2015
Last updated
04/20/2022
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