Montgomery Village Pain and Rehabilitation Center LLC

NPI #1053655639 in Montgomery Village, Maryland

Provider Information

NPI Number: 1053655639
Entity Type: Organization
Organization Name: Montgomery Village Pain and Rehabilitation Center LLC
Subpart: Yes (part of a larger organization)
Parent Organization: POTOMAC HEALTHCARE ALLIANCE LLC
Primary Specialty: Clinic/Center - Pain
Enumeration Date: Nov 20, 2012
Last Updated: Feb 25, 2015

Practice Location

Address: 19211 MONTGOMERY VILLAGE AVE
Address 2: SUITE B-12
City: Montgomery Village
State: Maryland
ZIP Code: 20886-5028
Phone: (240) 477-5452

Authorized Official

Name: PATRICK ESKEW
Title: CFO
Phone: (301) 625-5390

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Pain — Pain	261QP3300X	Primary

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