Organization
PRIMACARE PAIN & REHAB.,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KHAMIS W IBRAHIM D.C. (CLINIC DIRECTOR)
(404) 284-5556
Entity
Organization
Contact information
Practice address
4467 GLENWOOD RD, SUITE 2, DECATUR, GA 30032-5014
(404) 284-5556
(404) 284-5557
Mailing address
4467 GLENWOOD RD, SUITE 2, DECATUR, GA 30032-5014
(404) 284-5556
(404) 284-5557
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
019313
GA
Other
Enumeration date
04/30/2010
Last updated
04/30/2010
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