Organization
SOUTHEAST SPINE & PAIN ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIE LORD (CREDENTIALING/BILLING MANAGER)
(865) 633-9469
Entity
Organization
Contact information
Practice address
1718 SAINT MARY ST, KNOXVILLE, TN 37917-4517
(865) 633-9469
(865) 633-9474
Mailing address
PO BOX 27629, KNOXVILLE, TN 37927-7629
(865) 633-9469
(865) 633-9474
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531106
—
TN
Enumeration date
10/15/2012
Last updated
03/12/2015
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