Provider Demographics
NPI:1598013831
Name:TOTAL HEALTH PAIN CENTER
Entity Type:Organization
Organization Name:TOTAL HEALTH PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-241-7062
Mailing Address - Street 1:4150 SNAPFINGER WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-2711
Mailing Address - Country:US
Mailing Address - Phone:404-241-7062
Mailing Address - Fax:404-243-0357
Practice Address - Street 1:4150 SNAPFINGER WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-2711
Practice Address - Country:US
Practice Address - Phone:404-241-7062
Practice Address - Fax:404-243-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty