Organization
ATHENS ORTHOPEDIC AND PHYSICAL THERAPY CENTER PA
Active
Organization
ATHENS ORTHOPEDIC AND PHYSICAL THERAPY CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN LEE FAIN MD (PRESIDENT)
(903) 675-9526
Entity
Organization
Contact information
Practice address
1123 S PALESTINE ST, ATHENS, TX 75751-3646
(903) 675-9526
(903) 677-1815
Mailing address
1123 S PALESTINE ST, ATHENS, TX 75751-3646
(903) 675-9526
(903) 677-1815
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00917N
BLUE CROSS BLUE SHIELD
TX
05
—
081361001
—
TX
Enumeration date
10/13/2005
Last updated
02/02/2010
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