Healthcare Provider Details

I. General information

NPI: 1588009112
Provider Name (Legal Business Name): INTEGRATED SPINE & JOINT AT WESTHAVEN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WESTHAVEN BLVD STE 210
FRANKLIN TN
37064-4894
US

IV. Provider business mailing address

1025 WESTHAVEN BLVD STE 210
FRANKLIN TN
37064-4894
US

V. Phone/Fax

Practice location:
  • Phone: 615-465-6768
  • Fax:
Mailing address:
  • Phone: 615-465-6768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number16216
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0000002161
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number43546
License Number StateTN

VIII. Authorized Official

Name: BRIAN GRINDSTAFF
Title or Position: OWNER
Credential: DC
Phone: 812-798-1937