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General NPI Number Information
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NPI Number | 1235329160
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Entity Type | Organization
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Legal Business Name | WELLNESS PAIN & TREATMENT CENTER
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 535 JACK WARNER PKWY NE SUITE G1
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5751
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Country | US
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Telephone | 205-462-0969
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Fax | 205-562-1936
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Provider Business Mailing Address
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Address Line | 535 JACK WARNER PKWY NE SUITE G1
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5751
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Country | US
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Telephone | 205-462-0969
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Fax | 205-562-1936
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ELLIOT J RAMPULLA
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Credential | M.D.
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Telephone | 205-462-0969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 00016409
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License Number State | AL
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