Organization
MD PAIN RELIEF CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GANG LI M.D. (CHIEF EXECUTIVE MANAGER)
(410) 302-0700
Entity
Organization
Contact information
Practice address
10760 HICKORY RIDGE RD, SUITE 117, COLUMBIA, MD 21044-3682
(410) 302-0700
Mailing address
PO BOX 100, GLENELG, MD 21737-0100
(410) 302-0700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0053730
MD
Other
Enumeration date
03/23/2011
Last updated
07/05/2012
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