Healthcare Provider Details

I. General information

NPI: 1205488178
Provider Name (Legal Business Name): HEALTHCARE RESOURCE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 NEAL ST
COOKEVILLE TN
38501-0946
US

IV. Provider business mailing address

74 LEBANON HWY
CARTHAGE TN
37030-2954
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN DUBRAY
Title or Position: ADMINISTRATOR
Credential:
Phone: 615-735-8002