Organization
BANYAN HEALTHCARE & WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EDWARD ROTH M.D. (PRESIDENT)
(615) 943-9294
Entity
Organization
Contact information
Practice address
1030 MCARTHUR ST, MANCHESTER, TN 37355-2453
(931) 723-7950
(931) 723-7815
Mailing address
1030 MCARTHUR ST, MANCHESTER, TN 37355-2453
(931) 723-7950
(931) 723-7815
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
TN
Other
Enumeration date
10/17/2006
Last updated
04/04/2008
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