Provider Demographics
NPI:1497401343
Name:COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-483-4330
Mailing Address - Street 1:310 OVERLOOK RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3319
Mailing Address - Country:US
Mailing Address - Phone:828-483-4438
Mailing Address - Fax:
Practice Address - Street 1:22 TRUST LN STE 2
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4334
Practice Address - Country:US
Practice Address - Phone:828-368-4241
Practice Address - Fax:828-641-9058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty