Organization
PAIN TREATMENT CENTERS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM PETROV-KONDRATOV MD (PHYSICIAN OWNER)
(912) 910-3777
Entity
Organization
Contact information
Practice address
604 W OGLETHORPE HWY, HINESVILLE, GA 31313-4415
(912) 910-3777
(912) 292-0005
Mailing address
604 W OGLETHORPE HWY, HINESVILLE, GA 31313-4415
(912) 910-3777
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
09/22/2021
Last updated
12/16/2025
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