Provider Demographics
NPI:1861541492
Name:ANGEL PAIN RELIEF CENTER
Entity type:Organization
Organization Name:ANGEL PAIN RELIEF CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GATELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-632-2770
Mailing Address - Street 1:PO BOX 3077
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-7077
Mailing Address - Country:US
Mailing Address - Phone:770-632-2770
Mailing Address - Fax:770-632-2885
Practice Address - Street 1:6000 SHAKERAG HILL
Practice Address - Street 2:SUITE 108
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-7077
Practice Address - Country:US
Practice Address - Phone:770-632-2770
Practice Address - Fax:770-632-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty