Provider Demographics
NPI:1386029023
Name:ASSOCIATES COMPREHENSIVE PAIN MANAGEMENT CLINIC PLLC
Entity Type:Organization
Organization Name:ASSOCIATES COMPREHENSIVE PAIN MANAGEMENT CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-491-3901
Mailing Address - Street 1:29193 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 571
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1011
Mailing Address - Country:US
Mailing Address - Phone:202-607-1302
Mailing Address - Fax:
Practice Address - Street 1:29193 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 571
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1011
Practice Address - Country:US
Practice Address - Phone:202-607-1302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service