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General NPI Number Information
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NPI Number | 1396475877
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Entity Type | Organization
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Legal Business Name | TENNESSEE VALLEY BONE AND JOINT LLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 301 WHITE OAK RD
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City | DAYTON
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State | TN
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Zip | 37321-2530
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Country | US
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Telephone | 423-303-3634
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Fax | 423-303-3632
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Provider Business Mailing Address
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Address Line | PO BOX 11004
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City | CHATTANOOGA
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State | TN
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Zip | 37401-2004
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Country | US
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Telephone | 423-303-3634
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Fax | 423-303-3632
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Authorized Official
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Title or Position | BILLING / CREDENTIALING MANAGER
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Name | SHARM B PERRY
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Credential |
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Telephone | 423-303-3634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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