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Contact Information

BACK TO LIFE PAIN CENTER, LLC
410 CREEKSTONE RDG
WOODSTOCK, GA30188-3740
 Phone: 678-909-0911
 Fax: 678-909-0912
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for BACK TO LIFE PAIN CENTER LLC · (Female)

NPI # 1982172060
Status Active
Credentials
Entity Individual
Enumeration date 11/07/2018
Last updated 08/14/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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