Organization
PAIN TREATMENT CENTERS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM PETROV-KONDRATOV MD (PHYSICIAN OWNER)
(912) 910-3777
Entity
Organization
Contact information
Practice address
3760 US HIGHWAY 17 UNIT 11, RICHMOND HILL, GA 31324-3378
(912) 910-3777
(912) 292-0005
Mailing address
604 W OGLETHORPE HWY, HINESVILLE, GA 31313-4415
(912) 910-3777
(912) 292-0005
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
06/17/2024
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