Organization
PAIN CENTER AT PIEDMONT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. XAVIER ORLANDO BRENT JR. (PRACTICE MANAGER)
(678) 782-7999
Entity
Organization
Contact information
Practice address
1050 EAGLES LANDING PKWY STE 300, STOCKBRIDGE, GA 30281-9250
(678) 216-8934
Mailing address
1050 EAGLES LANDING PKWY STE 300, STOCKBRIDGE, GA 30281-9250
(678) 216-8934
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2018
Last updated
03/26/2019
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