Organization
PROGRESSIVE PAIN MANAGEMENT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY C LEACH (BILLING/COLLECTION SUPERVISOR)
(678) 736-6342
Entity
Organization
Contact information
Practice address
4646 N SHALLOWFORD RD, ATLANTA, GA 30338-6308
(770) 676-6000
Mailing address
4646 N SHALLOWFORD RD, ATLANTA, GA 30338-6308
(770) 676-6000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006247
GA
171100000X
Acupuncturist
000186
GA
207Q00000X
Family Medicine Physician
038861
GA
208D00000X
General Practice Physician
038861
GA
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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