Organization
LAKE OF THE OZARKS LASER PAIN CENTER LLC
Active
Other names
Back To Life Laser Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD EUGENE ADAMSON (PRESIDENT)
(573) 587-9046
Entity
Organization
Contact information
Practice address
1039 E US HIGHWAY 54 STE 100, CAMDENTON, MO 65020-6852
(573) 873-2755
(573) 873-2756
Mailing address
PO BOX 268, CAMDENTON, MO 65020-0268
(573) 873-2755
(573) 873-2756
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
02/13/2019
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