Organization
CHOICE PAIN & REBABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN SHOCKLEY (OWNER)
(240) 786-1001
Entity
Organization
Contact information
Practice address
5102 CORNELIAS PROSPECT DR, BOWIE, MD 20720-3375
(240) 786-1001
Mailing address
5102 CORNELIAS PROSPECT DR, BOWIE, MD 20720-3375
(240) 786-1001
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
D0068884
MD
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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