PROGRESSIVE PAIN MANAGEMENT, PC
Osteopathic Medicine at Shallowford Rd, Atlanta, GA

License number
Georgia 006247
Category
Chiropractic
Type
Chiropractor
License number
Georgia 000186
Category
Acupuncture
Type
Acupuncturist
License number
Georgia 038861
Category
Osteopathic Medicine
Type
Family Medicine
License number
Georgia 038861
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: MRS. MARY C LEACH
Title: BILLING/COLLECTION SUPERVISOR
Phone: (678) 736-6342
Address
Address
4646 N Shallowford Rd, Atlanta, GA 30338
National Provider ID: 1972807865
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PROGRESSIVE PAIN MANAGEMENT, PC

4646 N Shallowford Rd, Atlanta, GA 30338

Status:
Inactive
Registration:
Oct 22, 2010
Inactive since:
Jul 9, 2013
State ID:
10074095
Business type:
Domestic Profit Corporation
CFO:
Frank Matalone (CFO), 4646 N Shallowford Rd SUITE 111, Atlanta, GA 30338 (Physical)
Agent:
Otis L. Bonner,3430 Essex Ave, Atlanta, GA (Physical)

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