Organization
COMPREHENSIVE PAIN MEDICINE CENTER
Active
Parent organization
FAIRWAY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRWAY MEDICAL CENTER
Authorized official
MR. DAVID GUZAN (CEO)
(985) 809-9888
Entity
Organization
Contact information
Practice address
67230 INDUSTRY LN, STE 2, COVINGTON, LA 70433-8704
(985) 801-6285
(985) 801-6269
Mailing address
67230 INDUSTRY LN, STE 2, COVINGTON, LA 70433-8704
(985) 801-6285
(985) 801-6269
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
556
LA
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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