Healthcare Provider Details

I. General information

NPI: 1508022948
Provider Name (Legal Business Name): BELLE MEADE PAIN & SPINAL REHAB CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 HARDING RD SUITE 110
NASHVILLE TN
37205-2118
US

IV. Provider business mailing address

4515 HARDING RD SUITE 110
NASHVILLE TN
37205-2118
US

V. Phone/Fax

Practice location:
  • Phone: 615-269-5558
  • Fax: 615-269-5973
Mailing address:
  • Phone: 615-269-5558
  • Fax: 615-269-5973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number0000000167
License Number StateTN

VIII. Authorized Official

Name: DR. HENRY LOUIS OBERSTEADT
Title or Position: OWENER
Credential: DC
Phone: 615-269-5558