Organization
PERMIAN BACK TREATMENT CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL BROWN D.O. (ORGANIZER)
(432) 332-2858
Entity
Organization
Contact information
Practice address
1030 N GRANDVIEW AVE, ODESSA, TX 79761-3149
(432) 332-3388
(432) 332-3390
Mailing address
1030 N GRANDVIEW AVE, ODESSA, TX 79761-3149
(432) 332-3388
(432) 332-3390
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
5710
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
K4046
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
TX
Other
Enumeration date
10/18/2013
Last updated
04/16/2014
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