=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184287823
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TMS WELLNESS AMHERST LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2019
-----------------------------------------------------
Last Update Date | 04/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8750 TRANSIT RD STE 205
-----------------------------------------------------
City | EAST AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14051-2610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-268-1144
-----------------------------------------------------
Fax | 716-688-7345
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8750 TRANSIT RD STE 205
-----------------------------------------------------
City | EAST AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14051-2610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-905-5018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER/MANAGER
-----------------------------------------------------
Name | MR. CHRISTOPHER MEAD CATT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-905-5018
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 156F00000X
-----------------------------------------------------
Taxonomy Name | Technician/Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------