| NPI | 1982172060 |
|---|---|
| Doing Business As | BACK TO LIFE PAIN CENTER |
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN SERGEYEVICH TSYMBALOV Owner 678-909-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2020-08-14 |