Organization
MCMINNVILLE PAIN RELIEF CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT ANDERSON (ADMINISTRATOR)
(931) 474-1616
Entity
Organization
Contact information
Practice address
810 SPARTA ST STE 4, MCMINNVILLE, TN 37110-2698
(931) 474-1616
(931) 474-1618
Mailing address
810 SPARTA ST STE 4, MCMINNVILLE, TN 37110-2698
(931) 474-1616
(931) 474-1618
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
363AM0700X
Medical Physician Assistant
—
TN
363LF0000X
Family Nurse Practitioner
—
TN
Other
Enumeration date
11/23/2012
Last updated
09/19/2013
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