Organization
GEORGIA PAIN AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA BANKS (OFFICE MGR)
(678) 235-2401
Entity
Organization
Contact information
Practice address
552 PONCE DE LEON AVE NE, ATLANTA, GA 30308-1806
(678) 235-2401
(678) 235-2403
Mailing address
552 PONCE DE LEON AVE NE, ATLANTA, GA 30308-1806
(678) 235-2401
(678) 235-2403
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
02/08/2013
Last updated
02/08/2013
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