Provider Demographics
NPI:1912427220
Name:PRECISION PAIN RELIEF, INC
Entity Type:Organization
Organization Name:PRECISION PAIN RELIEF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-678-3809
Mailing Address - Street 1:958 N 3500 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-8850
Mailing Address - Country:US
Mailing Address - Phone:801-678-3809
Mailing Address - Fax:801-444-1228
Practice Address - Street 1:958 N 3500 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-678-3809
Practice Address - Fax:801-444-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10409805-0142332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT10409805-0142OtherSTATE OF UTAH