National Provider Identifier Database

BACK TO LIFE PAIN CENTER LLC
Pain Medicine

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.


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
* Pain Medicine 2081P2900X

* Indicates primary specialty

NPI Profile & details for BACK TO LIFE PAIN CENTER, LLC

NPI Number 1982172060
Legal business name
LBN
BACK TO LIFE PAIN CENTER, LLC
Authorized official KONSTANTIN TSYMBALOV - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/07/2018
Last updated 08/14/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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