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1790089720
PRESIDIO PAIN CENTER, LLC
FORT WORTH, TX
NPI
1790089720
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Entity Type
Organization
Authorized Contact
TED GROSBECK
Manager
469-362-6909
Organization Subpart ?
No
Primary Taxonomy
261QP3300X Clinic/Center, Pain
Enumeration Date
2011-01-05
Last Update Date
2011-01-05
Business Address
PRESIDIO PAIN CENTER, LLC
1201 SUMMIT AVE SUITE 400
FORT WORTH, TX 76102-4413
Phone number: 972-234-4740
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Mailing Address
PRESIDIO PAIN CENTER, LLC
PO BOX 702620
TULSA, OK 74170-2620
Phone number: 972-234-4740
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