Organization
PALMETTO PAIN MANAGEMENT OF GA, LLC
Active
Parent organization
PALMETTO PAIN MANAGEMENT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO PAIN MANAGEMENT, LLC
Authorized official
JENNIFER HODGE (PRACTICE ADMINISTRATOR)
(803) 779-3263
Entity
Organization
Contact information
Practice address
5745 CLARION ST, CUMMING, GA 30040-0305
(803) 779-3263
(803) 779-3207
Mailing address
1655 BERNARDIN AVE, SUITE 240, COLUMBIA, SC 29204-2039
(803) 779-3263
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
71017
GA
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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