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Organization

COOSA PAIN AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS KEVIN LACKEY MD (OWNER)
(256) 442-6181
Entity
Organization

Contact information

Practice address
3804 RAINBOW DR, RAINBOW CITY, AL 35906-3051
(256) 952-2200
(256) 952-2202
Mailing address
PO BOX 266, GADSDEN, AL 35902-0266
(256) 442-6181

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Enumeration date
08/02/2013
Last updated
06/22/2018
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