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Organization
SOUTHEAST TENNESSEE SPINE AND NERVE INSTITUTE PLLC
Active
Organization
SOUTHEAST TENNESSEE SPINE AND NERVE INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALL (CLINICDIRECTOR)
(423) 296-2604
Entity
Organization
Contact information
Practice address
1334 MACKEY BRANCH DR, SUITE 104, CHATTANOOGA, TN 37421-3471
(423) 296-2604
(423) 296-2607
Mailing address
1334 MACKEY BRANCH DR, SUITE 104, CHATTANOOGA, TN 37421-3471
(423) 296-2604
(423) 296-2607
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
04/07/2014
Last updated
06/23/2014
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