Provider Demographics
NPI:1447538061
Name:FAMILY PAIN MANAGEMENT LLC
Entity type:Organization
Organization Name:FAMILY PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAKELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALES-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-446-7201
Mailing Address - Street 1:3665 CLUB DR
Mailing Address - Street 2:STE 107
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1806
Mailing Address - Country:US
Mailing Address - Phone:678-288-6550
Mailing Address - Fax:800-609-0965
Practice Address - Street 1:4029 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1035
Practice Address - Country:US
Practice Address - Phone:404-366-5259
Practice Address - Fax:404-366-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty