Organization Name: | VONORE PAIN MANAGEMENT |
NPI Number: | 1922304500 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RETHA E ALEXANDER (OWNER/PRACTITIONER) |
Mailing Address: | 1255 Highway 411 Suite 6 Vonore |
State: | TN US |
Postal Code: | 378852457 |
Phone Number: | 4238843400 |
Fax Number: | 4238843401 |
NPI Enumeration Date: | 01/31/2011 |
NPI Last Update Date: | 01/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP3300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Pain |
Taxonomy Definition: |