| NPI | 1437565900 |
|---|---|
| Former Legal Business Name | CORDOVA PAIN SPECIALISTS, PLLC |
| Doing Business As | NORTHSTAR PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | JOHN WYATT MILES Authorized Official 901-444-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 2168) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 2168) |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2018-03-26 |