Organization
BECKLEY PAIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAKASH PURANIK MD (PRESIDENT)
(304) 237-2063
Entity
Organization
Contact information
Practice address
1902 HARPER RD, SUITE D, BECKLEY, WV 25801-2642
(304) 894-8817
Mailing address
1902 HARPER RD, SUITE D, BECKLEY, WV 25801-2642
(304) 894-8817
(304) 894-8924
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
02/21/2012
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