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General NPI Number Information
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NPI Number | 1265849228
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH AND WELLNESS CENTER OF NASHVILLE LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 2001 MALLORY LN SUITE 301
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City | FRANKLIN
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State | TN
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Zip | 37067-8233
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Country | US
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Telephone | 615-905-0120
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Fax | 615-778-2900
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Provider Business Mailing Address
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Address Line | 201 GREAT OAKS TRL
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City | WADSWORTH
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State | OH
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Zip | 44281-9430
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Country | US
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Telephone | 330-336-9500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON BUPP
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Credential | D.C.
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Telephone | 330-336-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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