| Organization Name: | PROLOTHERAPY NASHVILLE PLLC |
| NPI Number: | 1144548579 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK LANIER JOHNSON (OWNER) |
| Mailing Address: | 278 Franklin Road Suite 150 Brentwood |
| State: | TN US |
| Postal Code: | 37027 |
| Phone Number: | 6155060536 |
| Fax Number: | 6155071646 |
| NPI Enumeration Date: | 05/10/2010 |
| NPI Last Update Date: | 05/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | MD 20344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |