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Organization

COLQUITT REGIONAL PAIN CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDELL SIMS (CFO)
(229) 985-3420
Entity
Organization

Contact information

Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Mailing address
PO BOX 8866, GREENSBORO, NC 27419-0866

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Enumeration date
01/20/2016
Last updated
01/20/2016
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