Provider Demographics
NPI:1336925684
Name:PAINLOGICS LLC
Entity Type:Organization
Organization Name:PAINLOGICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YI
Authorized Official - Middle Name:
Authorized Official - Last Name:DING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:678-490-2255
Mailing Address - Street 1:490 SUN VALLEY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5642
Mailing Address - Country:US
Mailing Address - Phone:678-490-2255
Mailing Address - Fax:
Practice Address - Street 1:490 SUN VALLEY DR STE 103
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5642
Practice Address - Country:US
Practice Address - Phone:678-490-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation