Provider Demographics
NPI:1821494725
Name:JUSTIS PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:JUSTIS PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-990-0595
Mailing Address - Street 1:1201 SCHOOL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:806 HINES ST W
Practice Address - Street 2:SUITE B
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3022
Practice Address - Country:US
Practice Address - Phone:252-237-2461
Practice Address - Fax:252-399-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38991208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty