Healthcare Provider Details

I. General information

NPI: 1649033853
Provider Name (Legal Business Name): TENNESSEE REHABILITATION MEDICINE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 WILLIAMSON CT
BRENTWOOD TN
37027-8164
US

IV. Provider business mailing address

1805 WILLIAMSON CT
BRENTWOOD TN
37027-8164
US

V. Phone/Fax

Practice location:
  • Phone: 903-571-3844
  • Fax: 855-343-5763
Mailing address:
  • Phone: 903-571-3844
  • Fax: 855-343-5763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: WESLEY A PEACE
Title or Position: MEMBER
Credential:
Phone: 903-571-3844