Organization
PHYSICIAN'S PAIN AND SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RUSSELL GROSSLIGHT MD, JD (PRESIDENT/OWNER)
(803) 724-2336
Entity
Organization
Contact information
Practice address
3227-F SUNSET BLVD., SUITE 102, WEST COUMBIA, SC 29169-3201
(803) 724-2336
(803) 724-2317
Mailing address
3227-F SUNSET BLVD., SUITE 102, WEST COUMBIA, SC 29169-3201
(803) 724-2336
(803) 724-2317
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5286
—
SC
Enumeration date
10/22/2009
Last updated
02/17/2026
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