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General NPI Number Information
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NPI Number | 1376971085
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Entity Type | Organization
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Legal Business Name | QUALITY HEALTH CLINIC LLC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 7348 MIDDLEBROOK PIKE SUITE D
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City | KNOXVILLE
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State | TN
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Zip | 37909
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Country | US
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Telephone | 865-679-5985
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Fax | 865-381-1639
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Provider Business Mailing Address
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Address Line | 7348 MIDDLEBROOK PIKE D
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City | KNOXVILLE
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State | TN
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Zip | 37909
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Country | US
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Telephone | 865-679-5985
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Fax | 865-381-1639
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAMES D WADZINSKI
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Credential | M.D.
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Telephone | 865-679-5985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 42480
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License Number State | TN
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