| Organization Name: | MT. JULIET SPINE AND PAIN MANAGEMENT, PLLC |
| NPI Number: | 1124228416 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL ANTHONY SWIERCZ (OWNER) |
| Mailing Address: | 105 Industrial Dr Ste 7 Mount Juliet |
| State: | TN US |
| Postal Code: | 371223168 |
| Phone Number: | 6157587575 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2007 |
| NPI Last Update Date: | 03/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | APN0000012953 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |