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Provider Information for 1639102650

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CENTER FOR SPINE JOINT AND NEUROMUSCULAR REHAB PC.

Organization Subpart: NO

Organization NPI: 1639102650

Calendar   Last Updated:  2017-08-28
  Certification Date: 

Details

Name Value
NPI 1639102650
Enumeration Date 2006-07-10
NPI Type 2- Organization
Status Active
Authorized Official Information Name: DR. SON DIEP LE MD.
Title: OWNER/PHYSICIAN
Phone: 615-872-9966
Mailing Address 5651 FRIST BLVD STE 712
HERMITAGE, TN 37076-2061
United States

Phone: 615-872-9966 | Fax: 615-872-9967
View Map External Link
Primary Practice Address 5651 FRIST BLVD STE 712
HERMITAGE, TN 37076
United States

Phone: 615-872-9966 | Fax: 615-872-9967
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID TN 3377082
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193400000X SINGLE SPECIALTY GROUP
208100000X - Physical Medicine & Rehabilitation
TN 35117