NPI | 1902905573 |
---|---|
Former Legal Business Name | LEBANON PAIN MANAGEMENT CLINIC |
Entity Type | Organization |
Authorized Contact | TYROMA DENISE HENDRIX Owner Doctor 615-504-9735 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 7162) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 1874DC) |
363A00000X Physician Assistant (Licence: TN 1192PA) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2008-09-30 |