Organization
BACK TO LIFE PAIN CENTER, LLC
Active
Other names
Back To Life Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTANTIN SERGEYEVICH TSYMBALOV DO (OWNER)
(678) 909-0911
Entity
Organization
Contact information
Practice address
410 CREEKSTONE RDG, WOODSTOCK, GA 30188-3740
(678) 909-0911
(678) 909-0912
Mailing address
410 CREEKSTONE RDG, WOODSTOCK, GA 30188-3740
(678) 909-0911
(678) 909-0912
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
08/14/2020
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