Provider Demographics
NPI:1285183368
Name:PERIMETER PAIN SPECIALISTS
Entity Type:Organization
Organization Name:PERIMETER PAIN SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-467-5212
Mailing Address - Street 1:227 SANDY SPRINGS PL
Mailing Address - Street 2:SUITE D-120
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5918
Mailing Address - Country:US
Mailing Address - Phone:678-467-5212
Mailing Address - Fax:
Practice Address - Street 1:6690 ROSWELL RD STE 530
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3161
Practice Address - Country:US
Practice Address - Phone:678-467-5212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty