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General NPI Number Information
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NPI Number | 1528796364
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Entity Type | Organization
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Legal Business Name | OBN MANAGEMENT LLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 5625 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-3816
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Country | US
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Telephone | 833-777-3436
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Fax |
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Provider Business Mailing Address
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Address Line | 860 JOHNSON FY RD NE # 104-309
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City | ATLANTA
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State | GA
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Zip | 30342-1435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CHRISTOPHER SCHWAIGER
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Credential |
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Telephone | 630-418-2064
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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 |
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License Number State |
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