Organization
COOKEVILLE CENTER FOR PAIN MANAGEMENT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE D MARKS (BILLING MANAGER)
(931) 526-7104
Entity
Organization
Contact information
Practice address
580 S JEFFERSON AVE, COOKEVILLE, TN 38501-4672
(931) 526-7104
(931) 526-7105
Mailing address
PO BOX 4129, COOKEVILLE, TN 38502-4129
(931) 526-7104
(931) 526-7105
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
TN
363LF0000X
Family Nurse Practitioner
Primary
—
TN
Other
Enumeration date
11/27/2012
Last updated
02/20/2013
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