| NPI | 1962824482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD STEPHEN BOOMERSHINE Medical Director 615-355-0554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: TN 38402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 38402) |
| 207RR0500X Internal Medicine Rheumatology (Licence: TN 38402) | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |