Organization
LIBERTY SPINE AND PAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK LLOYD (VP OF ATHAS)
(214) 615-5168
Entity
Organization
Contact information
Practice address
263 W END AVE APT 22B, NEW YORK, NY 10023-2617
(214) 615-5168
(888) 526-9542
Mailing address
PO BOX 3837, CAROL STREAM, IL 60132-3837
(214) 615-5168
(888) 526-9542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0400479905
NJ
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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