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Organization
THREE RIVERS PAIN MANAGEMENT LLC
Active
Organization
THREE RIVERS PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA M. WARD (OFFICE MANAGER)
(803) 454-1661
Entity
Organization
Contact information
Practice address
169 MEDICAL CIR, SUITE A, WEST COLUMBIA, SC 29169-3655
(803) 454-1661
(803) 454-1660
Mailing address
169 MEDICAL CIR, SUITE A, WEST COLUMBIA, SC 29169-3655
(803) 454-1661
(803) 454-1660
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
17489
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17489
STATE LISCENSE NUMBER
SC
01
—
8327
PROVIDER NUMBER
SC
Enumeration date
05/05/2008
Last updated
02/09/2012
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