Healthcare Provider Details

I. General information

NPI: 1801163662
Provider Name (Legal Business Name): PAIN RELIEF AND MEDICAL SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 CAROTHERS PKWY SUITE 275
FRANKLIN TN
37067-5976
US

IV. Provider business mailing address

PO BOX 16068
HIGH POINT NC
27261-6068
US

V. Phone/Fax

Practice location:
  • Phone: 615-305-2096
  • Fax:
Mailing address:
  • Phone: 888-447-7220
  • Fax: 336-884-3615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MATT GRANT
Title or Position: COO
Credential:
Phone: 615-305-2096