# BOOMERSHINE WELLNESS CENTERS, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790078962
- **Authorized official:** DR. CHAD STEPHEN BOOMERSHINE M.D., PH.D. (CHIEF MANAGER)
- **Authorized official phone:** (615) 435-3235

## Contact information

- **Practice address:** 330 MALLORY STATION RD, SUITE E-15, FRANKLIN, TN 37067-2859
- **Practice address phone:** (615) 435-3235
- **Practice address fax:** (615) 435-3275
- **Mailing address:** 330 MALLORY STATION RD, SUITE E-15, FRANKLIN, TN 37067-2859
- **Mailing address phone:** (615) 435-3235
- **Mailing address fax:** (615) 435-3275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | 38402 | TN | Yes |

## Other

- **Enumeration date:** 05/22/2011
- **Last updated:** 11/21/2011