# PERMIAN BACK TREATMENT CENTER, PA

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

## Provider details

- **NPI number:** 1770911299
- **Authorized official:** DR. CARL BROWN D.O. (ORGANIZER)
- **Authorized official phone:** (432) 332-2858

## Contact information

- **Practice address:** 1030 N GRANDVIEW AVE, ODESSA, TX 79761-3149
- **Practice address phone:** (432) 332-3388
- **Practice address fax:** (432) 332-3390
- **Mailing address:** 1030 N GRANDVIEW AVE, ODESSA, TX 79761-3149
- **Mailing address phone:** (432) 332-3388
- **Mailing address fax:** (432) 332-3390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 5710 | TX | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | K4046 | TX | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | TX | Yes |

## Other

- **Enumeration date:** 10/18/2013
- **Last updated:** 04/16/2014