Organization
PIEDMONT COMPREHENSIVE PAIN MANAGEMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENNA LYNN (OFFICE MANAGER)
(864) 269-4416
Entity
Organization
Contact information
Practice address
100 HEALTHY WAY, SUITE 1260, ANDERSON, SC 29621
(864) 225-3551
(864) 328-0328
Mailing address
100 HEALTHY WAY, SUITE 1260, ANDERSON, SC 29621-2067
(864) 225-3551
(864) 328-0328
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
19980
SC
208VP0014X
Interventional Pain Medicine Physician
Primary
19467
SC
208VP0014X
Interventional Pain Medicine Physician
20828
SC
208VP0014X
Interventional Pain Medicine Physician
28639
SC
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2340
—
SC
Enumeration date
06/06/2006
Last updated
07/30/2018
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