Organization
PAIN MANAGEMENT & WELLNESS CENTERS OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABRAHAM COHEN (MANAGER)
(770) 680-5740
Entity
Organization
Contact information
Practice address
4905 LAVISTA RD, SUITE B, TUCKER, GA 30084-4409
(770) 680-5740
(770) 680-5754
Mailing address
4905 LAVISTA RD, SUITE B, TUCKER, GA 30084-4409
(770) 680-5740
(770) 680-5754
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
00228865
GA
261QP3300X
Pain Clinic/Center
Primary
00228865
GA
Other
Enumeration date
05/08/2012
Last updated
06/24/2015
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