Organization
CHOICE PAIN SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN SHOCKLEY (OWNER)
(240) 786-1001
Entity
Organization
Contact information
Practice address
18540 OFFICE PARK DR, MONTGOMERY VILLAGE, MD 20886-0586
(240) 786-1001
Mailing address
18540 OFFICE PARK DR, MONTGOMERY VILLAGE, MD 20886-0586
(240) 786-1001
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/30/2016
Last updated
12/30/2016
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