Organization
CHATTANOOGA SPINE & SPORT
Active
Organization
CHATTANOOGA SPINE & SPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOREN HEATH PEREZ MSPT (OWNER)
(423) 894-9893
Entity
Organization
Contact information
Practice address
2307 NAPIER RD STE 103, CHATTANOOGA, TN 37421-1827
(423) 894-9893
(423) 894-0992
Mailing address
2307 NAPIER RD STE 103, CHATTANOOGA, TN 37421-1827
(423) 894-9893
(423) 894-0992
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000004942
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4170264
BLUECROSS BLUESHIELD
TN
Enumeration date
02/21/2008
Last updated
02/21/2008
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