Healthcare Provider Details

I. General information

NPI: 1235004102
Provider Name (Legal Business Name): BODY SHOP FACE & BODY RESTORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 PEAVINE PLZ STE 101
CROSSVILLE TN
38571-7937
US

IV. Provider business mailing address

24 PEAVINE PLZ STE 101
CROSSVILLE TN
38571-7937
US

V. Phone/Fax

Practice location:
  • Phone: 931-202-2832
  • Fax:
Mailing address:
  • Phone: 931-202-2832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS ARTHUR ALLINGHAM
Title or Position: OWNER
Credential:
Phone: 931-484-9511